• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.103-116
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• 1996

This study was performed to observe the bacterial adhesion and penetration to e-PTFE membrane following guided tissue regeneration(GTR) procedure and to evaluate the association of the membrane exposure and bacterial contamination with the clinical outcome. For the study, ten infrabony defects in 9 patient were treated by mucoperiosteal flap operation including placement of the e-PTFE membrane. The treated teeth were monitored weekly for the membrane exposure, gingival recession and gingival inflammation. The membranes were retrieved after 4 to 6 weeks, examined by SEM for bacterial contamination and adherent connective tisue elements, and observed under LM for the bacterial penetration into membrane. Three months postsurgery, the defect sites were clinically reexamined for the changes in attachment level and probing depth. Comparison of the ultrastuctural findings and clinical outcome revealed that extent of membrane exposure and bacterial contamination of the membrane was inversely associated with clinical attachment gain. From this finding, the extent of membrane exposure and the bacterial contamination on the apical portion of the e-PTFE membrane at the time of removal seemed to be a critical determinant on the clinical outcome of GTR and the membrane exposure needs to be controlled for optimal results.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.117-132
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• 1996

The purpose of this study was to evaluate the bacterial adherence on e-PTFE membrane immersed in whole saliva from subjects with different periodontal status. Experiment involved 3 subject groups: 5 persons with healthy periodontium(probing depth below 3mm and no signs of gingival inflammation including bleeding on probing), 10 patients with gingivitis(probing depth below 3mm and apparent signs of gingival inflammation), and 10 patients with advanced periodontitis(probing depth over 7mm and apparent signs of gingival inflammation). Each disease group was included before and after scaling and root planing treatment. After obtaining whole saliva from each subject, e-PTFE membrane(Gore-Tex periodontal membrane : $GTPM^{(R)}$, W.L. Gore & Associates, Flagstaff, USA) specimens were immersed at room temperature in the saliva aliqouts for 1, 3, 7 days. The weight between pre - and post - immersion in saliva was measured with the analytical balance and the difference was recorded. The specimens were processed for SEM observation. The bacterial adherence on the membrane specimens was evaluated using the scanning electron microscope images. The obtained results were as follows : 1. There was no difference in the weight of bacteria adherent to e-PTFE membrane specimens according to the periodontal status and the immersion periods. 2. As the exposure time to saliva increased, the bacterial adherence to the membrane specimen significantly increased in all groups(P<0.005). 3. As the severity of periodontal disease increased, the bacterial adherence to the membrane specimens significantly increased(p<0.001). 4. After scaling and root planing, the bacterial adherence to the membrane specimens significantly decreased in gingivitis and periodontitis patient group(P<0.001). These results suggest that bacterial contamination on exposed barrier membrane surface be reduced through improvement of periodontal status and oral health environment before and after GTR procedure for the successful outcome.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.40-46
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• 1989

Destruction of normal temporomandibular joint architechture may produce serious functional and cosmetic deficiencies. The literature is well documented as to the etiology and pathogenesis of temporomandibular joints. Numorous surgical procedure have been advocated for temporomandibular joint ankylosis from condylectomy to arthroplasty, cartilage transplant, metallic prosthesis, interpositional implant. These were to able reconstruct the normal mandibular function, and any even procedure could obtain the satisfactory results. In this paper, we reviewed young adult patient with TMJ ankylosis and facial asymmetry who was treated with metallic condylar prosthesis and orthognathic surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.3.1-3.7
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• 2015

Hemifacial microsomia (HFM) is the most common craniofacial anomaly after cleft lip and cleft palate; this deformity primarily involves the facial skeleton and ear, with either underdevelopment or absence of both components. In patients with HFM, the management of the asymmetries requires a series of treatment phases that focus on their interception and correction, such as distraction osteogenesis or functional appliance treatment during growth and presurgical orthodontic treatment followed by mandibular and maxillary surgery. Satisfactory results were obtained in a 9-year-old girl with HFM who was treated with distraction osteogenesis. At the age of 19, genioplasty and mandible body augmentation with a porous polyethylene implant (PPE, $Medpor^{(R)}$, Porex) was sequentially performed for the functional and esthetic reconstruction of the face. We report a case of HFM with a review of the literature.

• The korean journal of orthodontics
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• v.39 no.6
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• pp.402-419
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• 2009

Successful treatment of the non-growing patient with an open bite of either dental skeletal pattern often presents a difficult challenge. The morphologic pattern in anterior open bite is characterized by longer vertical dimensions, an increase in development of the maxillary posterior dento-alveolar structure and a steep mandibular plane. In such cases, molar intrusion would be a good remedy for treatment. This article reports the successful treatment and retention of two anterior open-bite cases. We used orthodontic mini-implants for treatment and a circumferential retainer with posterior bite block or skeletal fixed retainer for retention. The diagnostic criteria and mechanics for appropriate treatment are discussed. Our results suggest that open bite can be reduced successfully with intrusion of molars using orthodontic mini-implants (OMI) without orthognathic surgery, and that circumferential retainer with posterior bite block and skeletal fixed retainer are effective for retention.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.74-77
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• 2015

Objectives: Transpositioning of the inferior alveolar nerve to prevent injury in lower jaw has been advocated for orthognathic, pre-prosthetic and for implant placement procedures. However, the concept of infra-orbital nerve repositioning in cases of mid-face fractures remains unexplored. The infraorbital nerve may be involved in trauma to the zygomatic complex which often results in sensory disturbance of the area innervated by it. Ten patients with infraorbital nerve entrapment were treated in similar way at our maxillofacial surgery centre. Materials and Methods: In this article we are reporting three cases of zygomatico-maxillary complex fracture in which intra-operative repositioning of infra-orbital nerve into the orbital floor was done. This was done to release the nerve from fractured segments and to reduce the postoperative neural complications, to gain better access to fracture site and ease in plate fixation. This procedure also decompresses the nerve which releases it off the soft tissue entrapment caused due to trauma and the organized clot at the fractured site. Results: There was no evidence of sensory disturbance during their three month follow-up in any of the patient. Conclusion: Infraorbital nerve transposition is very effective in preventing paresthesia in patients which fracture line involving the infraorbital nerve.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.963-979
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• 1999

This study examined ribotypes of 36 P. gingivalis strains isolated from 10 rapidly progressive periodontitis patients in Korean and revealed the presence of genetic heterogeneity among the patients. Ribotyping was performed by using a oligonucleotide probes based on 16S rRNA after whole genomic DNA had been digested with the restriction endonuclease enzyme Kpn I and Pst I. In addition, the antigenic heterogeneity of fimbrillin and protease activity was analysed to observe the virulency of P. gingivalis. The results were as follows. 1. Using KpnI, 6 ribotypes were detected, whereas 7 ribotypes were identified by using PstI. When combined two enzymes, a total of 8 ribotypes was subgrouped. 2. Ribotype I/e was the most common and detected in 4 among 10 patients. 3. The fimbrillin expressed from P. gingivalis isolates had the molecular size of 41kDa, 43kDa, 49kDa. It was observed that the size of fimbrillin with the same ribotypes could be identical. 4. All the P. gingivalis strains showed strong proteolytic activity and had the molecular size more than 120kDa. In summary, total 8 ribotypes were observed for isolates from rapidly progressive periodontitis patients. Forty percent of the patients harbored isolates exhibiting the same ribotype I/e, and it was observed that more than one ribotype can coexist in an individual patient.

• Archives of Plastic Surgery
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• v.42 no.3
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• pp.321-326
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• 2015

Background The acellular dermal matrix (ADM)-assisted breast reconstruction technique is widely known, but discouraging results due to early postoperative complications have been reported. As the literature identifies seroma as the most common issue after breast surgery without identifying its pathogenesis, we aimed to report the trend of postoperative daily serum collection after ADM-assisted breast reconstruction and compare it with data in the literature in order to discover more about this little-known topic. Methods A retrospective study on 28 consecutive patients who received ADM-assisted breast reconstruction between February 2013 and February 2014 was performed. In order to reduce the number of variables that could affect serum production, only one brand of ADM was used and all tissues were handled gently and precisely. The daily drainage volume was recorded per patient during the first four days of hospitalization. Likewise, postoperative complications were noted during routine follow-up. Results In total, five (17.9%) bilateral and 23 (82.1%) unilateral ADM-assisted breast reconstructions (33 implants) were performed. The mean age, body mass index, and length of hospital stay were 53.6 years, $21.3kg/m^2$, and 4.5 days, respectively. One major complication led to implant loss (3.0%), and nine minor complications were successfully treated with ambulatory surgery (27.3%). Serum collection linearly decreased after 24 hours postoperatively. Conclusions Daily drainage decreased following the theoretical decline of acute inflammation. In concordance with the literature, daily serum production may not be related to the use of ADM.

• Archives of Plastic Surgery
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• v.42 no.5
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• pp.601-607
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• 2015

Background Autologous or implant-based breast reconstruction after nipple-sparing mastectomy is increasingly preferred worldwide as a breast cancer treatment option. However, postoperative nipple-areola complex (NAC) necrosis is the most significant complication of nipple-sparing mastectomy. The purpose of our study was to identify the risk factors for NAC necrosis, and to describe the use of our skin-banking technique as a solution. Methods We reviewed cases of immediate autologous breast reconstruction after nipple-sparing mastectomy at our institution between June 2005 and January 2014. The patients' data were reviewed and the risk of NAC necrosis was analyzed based on correlations between patient variables and NAC necrosis. Moreover, data pertaining to five high-risk patients who underwent the donor skin-banking procedure were included in the analysis. Results Eighty-five patients underwent immediate autologous breast reconstruction after nipple-sparing mastectomy during the study period. Partial or total NAC necrosis occurred in 36 patients (43.4%). Univariate analysis and binary regression modeling found that body mass index, smoking history, radiation therapy, and mastectomy volume were significantly associated with NAC necrosis. Of the 36 cases of NAC necrosis, 31 were resolved with dressing changes, debridement, or skin grafting. The other five high-risk patients underwent our prophylactic skin-banking technique during breast reconstruction surgery. Conclusions NAC necrosis is common in patients with multiple risk factors. The use of the skin-banking technique in immediate autologous breast reconstruction is an attractive option for high-risk patients. Banked skin can be used in such cases without requiring additional donor tissue, with good results in terms of aesthetic and reconstructive outcomes.

• Archives of Plastic Surgery
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• v.47 no.4
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• pp.310-316
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• 2020

Background To produce patient-specific nasal implants, it is necessary to harvest and grow autologous cartilage. It is crucial to the proliferation and growth of these cells for scaffolds similar to the extracellular matrix to be prepared. The pore size of the scaffold is critical to cell growth and interaction. Thus, the goal of this study was to determine the optimal pore size for the growth of chondrocytes and fibroblasts. Methods Porous disc-shaped scaffolds with 100-, 200-, 300-, and 400-㎛ pores were produced using polycaprolactone (PCL). Chondrocytes and fibroblasts were cultured after seeding the scaffolds with these cells, and morphologic evaluation was performed on days 2, 14, 28, and 56 after cell seeding. On each of those days, the number of viable cells was evaluated quantitatively using an MTT assay. Results The number of cells had moderately increased by day 28. This increase was noteworthy for the 300- and 400-㎛ pore sizes for fibroblasts; otherwise, no remarkable difference was observed at any size except the 100-㎛ pore size for chondrocytes. By day 56, the number of cells was observed to increase with pore size, and the number of chondrocytes had markedly increased at the 400-㎛ pore size. The findings of the morphologic evaluation were consistent with those of the quantitative evaluation. Conclusions Experiments using disc-type PCL scaffolds showed (via both morphologic and quantitative analysis) that chondrocytes and fibroblasts proliferated most extensively at the 400-㎛ pore size in 56 days of culture.