• Archives of Plastic Surgery
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• 제38권1호
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• pp.15-18
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• 2011

Purpose: The anterior iliac crest is a common source for autologous cancellous bone graft. For patients who have previously received cancellous bone grafts from bilateral anterior iliac crests, there may be concerns of whether a sufficient quantity of autologous cancellous bone remains for additional grafts without harvesting it from other sites, such as the posterior iliac crest. Methods: We experienced 3 cases of reharvesting in 2 patients. The diagnosis of the first patient was bilateral facial cleft number 3. This patient received bilateral side cleft alveoloplasty with corticocancellous bone graft from the both anterior iliac crest respectively by a previous surgeon. This patient then needed reharvesting of the anterior iliac crest cancellous bone to correct an ongoing skeletal problem for the bilateral cleft. The other patient had bilateral incomplete cleft of the primary palate. This patient received left side cleft alveoloplasty with cancellous bone graft from the right anterior iliac crest. Before the patient could receive the alveoloplasty on the other side, a radial head osteotomy and cancellous bone graft was performed by orthopedic surgeons who then used the remaining left iliac crest in order to treat a pulled elbow. For the completion of the right side cleft alveoplasty, the anterior iliac crest cancellous bone needed to be reharvested. Prior to the reharvesting, a preoperative computed tomography scan of the pelvis was obtained to assess the maturity of the donor site regeneration. The grafts were then taken from site where a greater amount of regeneration was evident. Results: Long term follow ups showed that the grafts were successfully taken. This sufficient volume was obtainable 14 months after the first harvest. Conclusion: Satisfactory results were achieved after the reharvesting of iliac cancellous bone. Thus, it appears that the reharvesting of the iliac bone is a possible alternative to multiple site grafting, use of allograft or bone substitute materials.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.86-91
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• 2000

Autogenous bone graft is the useful technique for management of various bone defect in oral and maxillofacial surgery. The most common site for bone graft harvest is the anterior iliac crest. There is usually considerable cancellous bone graft available and it can be obtained with minimal morbidity. However, complications noted in iliac crest grafts include prolonged postoperative pain, hematoma and fracture, gluteal muscle weakness. Occasionally, when large amounts of bone graft are needed and previous harvest procedure had used, iliac bone harvest may be not adequate. Like the iliac crest, the greater trochanter has abundant cancellous bone and is readily accessible with acceptable morbidity. The purpose of this study was to assess the availability of cancellous bone graft from the greater trochanter, compare the quantity with that available from the anterior iliac crest, investigate anatomical hazards, and make recommendations for consistent harvest.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권4호
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• pp.386-390
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• 2007

This is about the case of loss of multiple teeth and alveolar bone caused by trauma, which needed alveolar bone augmentation before implant treatment. Alveolar bone was reconstructed using iliac bone graft, and thereafter first implant surgery was followed by consolidation period of 3 months. Iliac bone resorption was observed at the time of implant placement. And that resorption was more in the horizontal dimension than in the vertical. We conclude that additional treatment planning(e.g. using alveolar distraction osteogenesis or tissue expander) should be considered besides bone graft for vertical alveolar bone augmentation. For both maxilla and mandible, prosthodontic treatment was carried out $4{\sim}5$ months after implant placement. To compensate alveolar bone deficiency, partial hybrid overdenture on maxilla and implant-supported fixed bridge on mandible were fabricated, and the total treatment was finished.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권6호
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• pp.570-578
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• 2006

A severely atrophic maxilla may disturb the proper implant placement. The various bone graft techniques are required for simultaneous or delayed implantation in the cases of atrophic alveolar ridges. We present 11 consecutive patients treated with simultaneous implantation using the autogenous inlay and/or onlay bone grafts from iliac crest to the floor of the maxillary sinus and the alveolar crest. In the cases of atrophic maxilla, a total 69 implants were simultaneously placed with autogenous iliac bone graft. 40 fixtures were inserted in the sinus floor simultaneously with subantral block bone graft, the other 29 fixtures were placed in the anterior or premolar areas with block or particulate bone graft. The vertical alveolar bone height was measured with Dental CT at the preoperation and 6 months postoperation. Moreover, the implant stability quotients (ISQ) were measured by $Osstell^{TM}$ during second implant surgery at 6 months later of first implantation. All implants were obtained successful osseointegration with the grafted bone. The mean vertical increases were 3.9mm in the anterior ridges and 12.8mm in the posterior ridges. During the second implant surgery, mean ISQ were 62.95 in the anterior ridge and 61.32 in the posterior ridge. We concluded that the simultaneous implantation with autogenous iliac bone graft were stable and available methods for severely atrophic maxilla.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.398-403
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• 2012

Purpose: Mandible resection and discontinuity defect created lead to aesthetic and functional problems. The iliac crest bone graft exhibits relative ease for bone harvesting, possibility of two team approach, ability to close the wound primarily, large amount of corticocancellous bone and relatively few complications. Whereas the use of free vascularized flaps has donor site morbidity and worse-fitting bone contour, the use of nonvascularized iliac bone graft has advantages in the operation time and patients' recovery time. So, nonvascularized iliac bone graft could be an attractive option. Methods: Twenty-one patients (M:F=1:1.1) underwent iliac crest bone harvesting for reconstruction of mandibular discontinuity defect (mean length : $61.6{\pm}17.8$ mm), from May 2005 to October 2011 at the Department of Oral and Maxillofacial Surgery in Kyungpook National University. The average age was $44.1{\pm}16.4$ years and the mean follow up periods was $28.2{\pm}22.7$ months. Bone resorption rate, according to age, sex, primary lesion, location and distance of defect, type of fixation plate, time of graft and pre-operative radiation therapy, were measured in each patient. Results: The mean bone resorption rate was $16.1{\pm}9.0%$. Bone resorption rate was significantly increased in mandibular defect that is over 6 cm in size (P=0.015, P<0.05) and the cases treated pre-operative radiation therapy (P=0.017, P<0.05). All was successfully fixed and maintained for the long-term follow-up. There were a few donor site complications and almost all patients were shown favorable outcome without severe bone resorption in this study. Conclusion: The nonvascularized iliac bone graft seems to be a reasonably reliable treatment option for reconstruction of mandibular discontinuity defects.

• 대한치과의사협회지
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• 제22권1호통권176호
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• pp.37-48
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• 1984

Clinical assessment of bone-graft healing in the maxillofacial region is generally limited to clinical evaluation, radiographs, and biopsy. Sequential interpretation of osseous repair, more sensitive than with conventional radiography is possible with a non-invasive, non-destructive radionuclide method. Technetium-99m radionuclide bone scan was used in the evaluation of the progress of osteogenic activity in autologous iliac bone graft and freeze-dried bone allograft of dog's mandible. Bone scan was performed at 1wk, 2wk, 4wk, 6wk, and 8wk after grafting. In autologous graft the activity ratio for the graft bone remained greater than that of the host since 2자 after grafting; however, in lyophilized allograft the activity ratio for graft bone was greater than that of the host at 6자 after grafting.

• Archives of Plastic Surgery
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• 제45권6호
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• pp.588-592
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• 2018

Harvesting grafts from the anterior iliac bone has been associated with various complications. A 50-year-old woman presented to our department with a chief complaint of right inguinal swelling and pain. Autologous bone grafts had been harvested on two previous occasions from the right anterior iliac crest for use in the reconstruction of multiple facial fractures. Computed tomography and magnetic resonance imaging revealed a full-thickness bone defect in the right anterior iliac crest. A mass was noted in the right gluteus minimus, while a multilocular cystic mass extended from the right iliac crest defect to the right inguinal region. Both the inguinal mass and gluteal mass were removed under general anesthesia. Following histopathological analysis, the gluteal mass was diagnosed as a venous malformation (VM). Based on the patient's clinical course, iliac bone graft harvesting and trauma to the gluteal region triggered hemorrhaging from the VM. Blood components leaked out from the fragile portion of the iliac bone defect, forming a cystic lesion that developed into the inguinal mass. In this case, a coincidental VM resulted in a rare complication of iliac bone graft harvesting. These sequelae could have been avoided by planning for more appropriate ways to collect the grafts.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권2호
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• pp.189-191
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• 2001

Objective : The objective of this study was to determine which forms of iliac cancellous bone grafts better restore alveolar clefts. Study design : Forty consecutive patients who required a unilateral alveolar cleft graft were studied. Group I (20 patients) had reconstruction with iliac cancellous particulate bone grafts and group II (20 patients) had reconstruction with iliac cancellous block bone grafts. The two groups were evaluated radiographically and clinically. Results : The group with the block bone grafts showed less postoperative problems and better incorporation of the bone graft than the group with the particulate grafts. Conclusion : Surgical reconstruction of alveolar process defects in patients with alveolar cleft using iliac cancellous block bone is a more reliable method than particulate bone grafts both for closing the oronasal fistula and for building interalveolar septal height.

• Clinics in Shoulder and Elbow
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• 제13권1호
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• pp.117-122
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• 2010

목적: 본 증례 보고는 간질 발작과 동반된 심한 전방 관절와 골결손에 의한 견관절 불안정성에서 자가 삼면피질 장골 이식술을 통한 관절와 재건술 및 안정화 술식을 시행한 증례를 문헌 고찰과 함께 보고하고자 한다. 대상 및 방법: 간질 발작과 동반된 심한 전방 관절와 골결손을 가진 2예의 재발성 전방 탈구를 자가 삼면 피질 장골 이식술을 이용하여 관절와 재건술 및 안정화 술식을 이용하여 치료하였다. 결과: 수술 후 5개월째 단순방사선 촬영상 이식골의 유합 소견이 관찰되었고, 수술 전 소견과 비교해서 골관절염의 진행소견은 관찰되지 않았다. 수술 후 7개월 추시 관찰 상 통증은 거의 없었으며, 관절 운동 범위는 정상 운동 범위를 보였으며, 관절의 안정성을 확보하였다. 결론: 심한 전방 관절와 골결손을 가진 재발성 전방 탈구는 충분한 골 이식을 통해 전방 안정성을 얻을 수 있으며, 관절 면을 비교적 잘 일치시켜 정상 관절와의 오목함을 재건할 수 있고 관절염의 빈도를 줄일 수 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권4호
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• pp.353-360
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• 2007

In a one-stage approach, where the implant installation is performed simultaneously with the iliac bone graft, various complications are observed. The observed complications are as follows; severe bone resorption at the maxillary anterior region and the area adjacent to the nasal cavity, shortage of soft tissue to cover the augmented alveolar bone, difficulties with oral hygiene care caused by the diminished vestibular space and non-esthetic prosthesis. These are good reasons for choosing the two-stage approach over the one-stage approach in spite of all the advantages it has, and should be taken into careful consideration when diagnosing and planning treatment using the one-stage approach.