• Clinics in Shoulder and Elbow
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• 제24권4호
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• pp.245-252
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• 2021

Background: In patients with total elbow arthroplasty (TEA), the soft-tissue around the elbow can be vulnerable to soft-tissue complications. This study aims to assess the outcomes after soft-tissue reconstruction following TEA. Methods: We retrospectively included nine adult patients who underwent soft-tissue reconstruction following TEA. Demographic data and disease characteristics were collected through medical chart reviews. Additionally, we contacted all four patients that were alive at the time of the study by phone to assess any current elbow complications. Local tissue rearrangement was used for soft-tissue reconstruction in six patients, and a pedicle flap was used in three patients. The median follow-up period was 1.3 years (range, 6 months-14.7 years). Results: Seven patients (78%) underwent reoperation. Four patients (44%) had a reoperation for soft-tissue complications, including dehiscence or nonhealing of infected wounds. Five patients (56%) had a reoperation for implant-related complications, including three infections and two peri-prosthetic fractures. At the final follow-ups, six patients (67%) achieved successful wound healing and two patients had continued wound healing issues, while two patients had an antibiotic spacer in situ and one patient underwent an above-the-elbow amputation. Conclusions: This study reports a complication rate of 78% for soft-tissue reconstructions after TEA. Successful soft-tissue healing was achieved in 67% of patients, but at the cost of multiple surgeries. Early definitive soft-tissue reconstruction could prove to be preferable to minor interventions such as irrigation, debridement, and local tissue advancement, or smaller soft-tissue reconstructions using local tissue rearrangement or a pedicled flap at a later stage.

• Restorative Dentistry and Endodontics
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• 제47권4호
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• pp.41.1-41.20
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• 2022

Objectives: This study compared the clinical and radiological outcomes of regenerative endodontic procedures (REPs) using blood clots (BCs), platelet-rich plasma (PRP), and platelet-rich fibrin (PRF) through intraoral periapical radiography (IOPAR) and cone-beam computed tomography (CBCT). Materials and Methods: Forty-five single-rooted necrotic teeth with periapical pathology were randomly allocated to receive BC, PRP, or PRF as an individual scaffold. Outcomes were evaluated in 35 teeth in 23 patients with a follow-up period of 12-24 months through qualitative IOPAR scoring and quantitative CBCT measurements. Healing of periapical lesions and in immature teeth, changes in the apical foramen diameter (AFD), root wall thickness (RWT), and root length (RL) were assessed. A p value less than 0.05 was considered to indicate statistical significance. Results: All teeth were asymptomatic except 1 in the PRP group. Periapical lesion healing was seen in all except 2 teeth in the BC group and 3 in the PRP group. Both IOPAR and CBCT revealed no significant differences in bone healing or changes in AFD, RWT, and RL among the 3 groups. A positive pulp sensibility response to the cold test was seen in 2 teeth in the BC group, but none to the electric pulp test. Intracanal calcification (ICC) was evident in more teeth in the BC group than in the PRP and PRF groups, and was also significantly higher in immature teeth. Conclusions: Our results revealed that BC, PRP, and PRF have similar potential as scaffolds in REPs, and ICC may be a concern for long-term outcomes.

• 대한치과의사협회지
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• 제49권3호
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• pp.159-169
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• 2011

The author have been conducting research on the development of biomaterials using human teeth since 1993, and we recently reported the results of several of our advanced studies. Based on previous studies, new bone graft material using autogenous tooth(AutoBT) was developed. The author performed implant placement combined with GBR and sinus bone graft using AutoBT during the period of June 2009 to September 2009. During the postsurgical healing period, clinical and radiological evaluations were performed. For patients who consented to histological testing, tissue samples were obtained and histological examination was performed two months and four months after GBR and four months after sinus bone graft. Serious complications pertinent to bone graft materials were not observed, and it was shown that the level of the crestal bone in the vicinity of implants was relatively well maintained. In histologic examination after two months and four months, favorable new bone formation was observed.

• Neonatal Medicine
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• 제25권4호
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• pp.191-195
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• 2018

Leukocyte adhesion deficiency is a rare primary immunodeficiency and autosomal recessive disorder caused by a mutation in the gene encoding CD18, which is a constituent of leukocyte integrins. Clinical features usually begin with a delay in the separation of the umbilical cord in the neonatal period, and are characterized by marked leukocytosis with infection, delayed wound healing, and repeated bacterial and fungal infections. We experienced a case of leukocyte adhesion deficiency diagnosed in the neonatal period, in which a late preterm infant admitted to neonatal intensive care unit presented with a septic hip. Flow cytometry analysis of whole blood showed a decrease in the expression of CD11b/CD18. This is the first case of leukocyte adhesion deficiency with neonatal septic hip diagnosed in Korea.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권1호
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• pp.14-26
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• 1990

This study was undertaken to observe the histopathologic changes of the extraction wounds of diabetic rats when exposed to hyperbaric oxygen. A total of 50 rats (Spraque-Dawley strain) were used, which were all induced with diabetes using streptozotocin before the experiment. The experimental group was exposed to hyperbaric oxygen at 2.5atm. for 2 hours a day during the experimental period. The obtained results were summarized as follows : 1. Severe infiltration of inflammatory cells was observed in the initial stages of both the control and experimental groups. The infiltration showed a decreasing tendency at 3rd week in the experimental group, while severe inflammatory infiltration observed in the control group during the entire experimental period. 2. There was abundant proliferation of capillary blood vessels at 1st week after extraction in the experimental group, while moderate capillary growth in the control group was observed at 1st week after extraction. 3. Osteoblastic activity was started at 1st week after extraction in the experimental group, but there showed markedly delayed appearance in the control group, which showed at 2nd week after extraction. 4. The proliferation of fibroblasts showed rather in the experimental group at 1st week, but it was moderate in the control group at 1st week, 2nd week and 3rd week. 5. Epithelialization of the extraction wound was started at 2 days after extraction and reached its peak at 3rd week in the experimental group, while control group seemed to be delayed and incompleted during the experiment. With regard to these results, hyperbaric oxygen therapy disclosed an effective results on the healing of the extraction wound in diabetic rats under exposure at 2.5 atm for 2 hours daily.

• Journal of Periodontal and Implant Science
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• 제38권4호
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• pp.729-736
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• 2008

Purpose: Anterior ridge defect after tooth extraction results in unfavorable appearance. Ridge augmentation procedures should be preceded by careful surgical-prosthetic treatment planning, and various techniques can be used in anterior ridge augmentation. Materials and Methods: Three patients showed deformed ridges after tooth extraction. Three different techniques ; onlay-interpositional connective tissue graft; bovine hydroxyapatite graft with free connective tissue graft; bovine hydroxyapatite graft with resorbable collagen membrane following free connective tissue graft; were used for anterior ridge augmentation. Result: Soft tissue graft can be used in small amount of ridge defect, hard tissue graft combined with soft tissue graft can be used in large amount of ridge defect. After ridge augmentation, about three months of healing period, augmented tissue was stabilized. The final restoration was initiated after this healing period, and the tissue form was maintained stable. Conclusion: Careful diagnosis and surgical-prosthetic treatment planning with joint consultation prior to surgery should be performed in order to attain an optimal esthetic results.

• Journal of Periodontal and Implant Science
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• 제31권1호
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• pp.57-74
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• 2001

The purpose of this study was to evaluate the adjunctive combined effect of demineralized freeze-dried bone allograft(DFDB) in guided bone regeneration on supra-alveo-lar peri-implant defect. Supra-alveolar perio-implant defects, 3mm in height, each including 4 IMZ titanium plasma-sprayed implants were surgically created in two mongrel dogs. Subsequently, the defects were treated with 1 of the following 3 modalities: Control) no membrane or graft application, Group1) DFDB application, Group2) guided bone regeneration using an expanded polytetra-fluoroethylene membrane, Group3) guided bone regeneration using membrane and DFDB. After a healing period of 12-week, the animals were sacrificed, tissue blocks were harvested and prepared for histological analysis. Histologic examination were as follows; 1. New bon formation was minimal in control and Group 1, but considerable new bone formation was observed in Group 2 and Group 3. 2. There was no osteointegration at the implant-bone interface in the high-polished area of group2 and Group 3. 3. In fluorescent microscopic examination, remodeling of new bone was most active during week 4 and week 8. There was no significant difference in remodeling rate between group 2 and group 3. 4. DFDB particles were observed, invested in a connective tissue matrix. Osteoblast activity in the area was minimal. The results suggest that guided bone regeneration shows promising results in supra-alveolar peri-implant defects during the 12 week healing period although it has a limited potential in promoting alveolar bone regeneration in the high-polished area. There seems to be no significant adjunctive effect when DFDB is combined with GBR.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.653-658
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• 2008

Purpose: Skin and soft tissue defect is one of the major challenges faced by plastic surgeons. Adipose derived stromal cells, which can be harvested in large quantities with low morbidity, display multilineage mesodermal potential. Therefore, adipose derived stromal cells have been met with a great deal of excitement by the field of tissue engineering. Recently, Adipose derived stromal cells have been isolated and cultured to use soft tissue restoration. In order to apply cultured cells for clinical purpose, however, FDA approved facilities and techniques are required, which may be difficult for a clinician who cultures cells in a laboratory dedicated to research to utilize this treatment for patients. In addition, long culture period is needed. Fortunately, adipose derived stromal cells are easy to obtain in large quantities without cell culture. The purpose of this study is to present a possibility of using uncultured adipose derived stromal cells for wound coverage. Methods: Seven patients who needed skin and soft tissue restoration were included. Five patients had diabetic foot ulcers, 1 patient got thumb amputation, and 1 patient had tissue defect caused by resection of squamous cell carcinoma. The patients' abdominal adipose tissues were obtained by liposuction. The samples were digested with type I collagenase and centrifuged to obtain adipose derived stromal cells. The isolated adipose derived stromal cells were applied over the wounds immediately after the wound debridement. Fibrin was used as adipose derived stromal cells carrier. Occlusive dressing was applied with films and foams and the wounds were kept moist until complete healing. Results: One hundred to one hundred sixty thousand adipose derived stromal cells were isolated per ml aspirated adipose tissue. All patients' wounds were successfully covered with the grafted adipose derived stromal cells in a 17 to 27 day period. No adverse events related to this treatment occurred. Conclusion: The use of uncultured adipose derived stromal cells was found to be safe and effective treatment for wound coverage without donor site morbidity.

• 대한치과보철학회지
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• 제59권3호
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• pp.314-318
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• 2021

미만성 경화성 골수염(diffuse sclerosing osteomyelitis, DSO) 환자에서 임플란트를 사용하여 손실된 치아의 회복에 대한 보고는 거의 없다. DSO 환자는 임플란트의 골유착에 불리한 골질을 지니고 있기 때문에 임플란트를 식립할 때, 외과적 외상, 감염 관리 및 연장된 치유 기간과 같은 추가적인 고려사항이 필수적이다. 본 증례는 DSO 환자에서 임플란트 골유착의 실패와 성공에 관한 보고이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권2호
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• pp.107-111
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• 2010

Purpose: The aim of this study is to compare the stability between Mg-incorporated implant, TiUnite and Machined implant. Materials and Methods: Premolars of 3 Mini pigs (24 months) were extracted. After 2 months later, total 27 fixtures of implants (9 of each design : Machined/ TiUnite/ Mg-incorporated) were inserted into the mandible of 3 mini-pig. Implant stability was estimated by RFA in installation to 2, 4 & 6 weeks. Statistical analysis of RFA values was performed with time and between groups using repeated measure ANOVA and turkey's multiple comparison test. Results: In analyzing the mean value for the observation periods, three types of implants yielded a slight decrease in RFA mean value after 2 week, followed by increase at 4-6 weeks. Mg incorporated oxidized implants demonstrated significantly higher RFA mean values at 6 weeks comparing other groups. The difference of RFA value with time and between groups was statistically significant. Conclusion: We concluded that Mg implants may reduce failure rates of clinical implants In the early period of bone healing and Mg implants may shorten the bone healing time from surgery to functional loading.