• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.6
• /
• pp.666-671
• /
• 2000

Objectives: This study evaluated the availability of mandibular symphysis corticocancellous block grafts in patients treated for reconstruction of intraoral jaw defects. Materials & Methods: 8 patients with mandibular and maxillary bony defects were treated with corticocancellous block of symphysis. The types of defects included 4 pathologic jaw defects and 4 vertical and/or horizontal alveolar deficiencies. The age ranged from 13 to 45 years. Additional treatments such as plate fixation, alloplastic bony substitutes, and/or barrier membrane application were perfomred. They were evaluated for complications and healing of defects. Follow-up period ranged from 6 to 15 months. Results: 2 patients experienced complications such as wound dehiscence and mild resorption of exposed bone. None of the patients needed secondary operation. Paresthesia of lip, chin, and teeth were recovered completely by 6 months postoperatively. Reconstructed wound showed favorable healing and bony consolidation. Conclusion: Corticocancellous block of mandibular symphysis can be used for the reconstruction of a variety of intraoral local jaw defects selectively. Advantages were easy fixation of graft, possibility of restoration of original alveolar contour, and decreased donor site morbidity.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.47 no.2
• /
• pp.99-111
• /
• 2021

Objectives: It is unclear whether the extent of intraoral mucosa defects in patients with medication-related osteonecrosis of the jaw indicates disease severity. Therefore, this study investigated whether mucosal lesions correlate with the true extent of osseous defects in stage I patients. Materials and Methods: Retrospectively, all patients with stage I medication-related osteonecrosis of the jaw who underwent surgical treatment between April 2018 and April 2019 were enrolled. Preoperatively, the extent of their mucosal lesions was measured in clinical evaluations, and patients were assigned to either the visible or the probeable bone group. Intraoperatively, the extent of necrosis was measured manually and with fluorescence. Results: Fifty-five patients (36 female, 19 male) with 86 lesions (46 visible bone, 40 probeable bone) were enrolled. Intraoperatively, the necrotic lesions were significantly larger (P<0.001) than the preoperative mucosal lesions in both groups. A significant (P<0.05) but very weak (R2<0.2) relationship was noted between the extent of the mucosal lesions and the necrotic bone area. Conclusion: Preoperative mucosal defects (visible or probeable) in patients with medication-related osteonecrosis of the jaw do not indicate the extent of bone necrosis or disease severity.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.39
• /
• pp.5.1-5.9
• /
• 2017

Many congenital and acquired defects occur in the maxillofacial area. The buccal fat pad flap (BFP) is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various intraoral defects. In this article, we have reviewed BFP and the associated anatomical background, surgical techniques, and clinical applications. The surgical procedure is simple and has shown a high success rate in various clinical applications (approximately 90%), including the closure of oroantral fistula, correction of congenital defect, treatment of jaw bone necrosis, and reconstruction of tumor defects. The control of etiologic factors, size of defect, anatomical location of defect, and general condition of patient could influence the prognosis after grafting. In conclusion, BFP is a reliable flap that can be applied to various clinical situations.

• Journal of Korean Dental Science
• /
• v.7 no.1
• /
• pp.38-42
• /
• 2014

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is defined as exposed necrotic bone without evidence of healing for at least 8 weeks in the maxillofacial area in a patient with history of bisphosphonate use. Obtaining complete coverage of the hard tissue by soft tissue in BRONJ patients is especially important. Therefore, managing the mucosa is one of the key factors in a successful outcome, but this is especially hard to achieve in BRONJ patients. Various applications of buccal fat pad in oral reconstruction-including the closure of surgical defects following tumor excision, repair of surgical defects following the excision of leukoplakia and submucous fibrosis, closure of primary and secondary palatal clefts, coverage of maxillary and mandibular bone grafts, and lining of sinus surface of maxillary sinus bone graft in sinus lift procedures for maxillary augmentation-have been studied. Eliminating all potential sites of infection and post-operative infection control is crucial in BRONJ. We present a case using the buccal fat pad pedicle for a stage 3 BRONJ defect. Uneventful total epithelialization of the buccal fat pad regardless of size was noted. In summary, the buccal fat pad has versatile application and various recipient sites for surgical utilization. It is an easy technique, with promising overall success rates. With careful selection and handling, buccal fat graft can resolve problems with soft tissue coverage in stage 2 or 3 BRONJ patients.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.36 no.1
• /
• pp.25-29
• /
• 2014

The purpose of this study is to report on five cases treated with bone graft using recombinant human bone morphogenetic protein-2 (rhBMP-2) on jaw defects after cyst enucleation. We performed bone graft with BMP (rhBMP-2+${\beta}$-tricalcium phosphate/hydroxyapatite) wrapped with a collagen sponge on jaw defects after cyst enucleation. Postoperative panoramic radiographs were taken periodically. After 1 to 12 months, bone remodeling was observed in the jaw defect area. In our cases, there were few signs or symptoms of recurrence of the cyst during the follow-up period.

• Asian-Australasian Journal of Animal Sciences
• /
• v.24 no.8
• /
• pp.1053-1059
• /
• 2011

The objective of this study was to assess the teratogenic and embryotoxic effects of clomiphene citrate in mice. The pregnant mice were administered a single dose of clomiphene citrate at different concentrations i.e 1.0, 2.0, 4.0 and 6.0 ${\mu}g/g$ BW on day 8 of gestation. Fetuses recovered on day 18 of gestation were analyzed on morphological, morphometric and histological basis. Morphological observations showed defects like open eyelids, anophthalmia, fore and hindlimb micromelia, meromelia, amelia, sacral hygroma, hydrocephaly, hemorrhagic spots, kyphosis and clubbed feet. Morphometric analysis indicated a significant (p<0.001) reduction in fetal body weight, crown rump length, head circumference, eye circumference, forelimb and hindlimb lengths and tail size against controls. The histological observations showed brain defects like hydrocephaly, enlarged ventricles and undifferentiated neuroglial cells in cerebellum. Cleft palate, underdeveloped pharynx and atrophy of jaw muscles were the common anatomical defects of pharyngeal region. It is concluded that the concentrations of clomiphene citrate used during the present study proved teratogenic in mice fetuses.

• Journal of Periodontal and Implant Science
• /
• v.38 no.2
• /
• pp.171-178
• /
• 2008

Purpose: The aim of this study was to evaluated biphasic calcium phosphate applied in surgically created 1-wall periodontal intrabony defects in dogs by histometrical analysis. Material and Method: Critical sized($4\;mm\;{\times}\;4\;mm$), one wall periodontal intrabony defects were surgically produced at the proximal aspect of mandibular premolars in either right and left jaw quadrants in four canines. The control group was treated with debridement alone, and experimental group was treated with debridement and biphasic calcium phosphate application. The healing processes were histologically and histometrically observed after 8 weeks. Results: In biphasic calcium phosphate group, more new bone and cementum formation, less epithelium and connective tissue attachment were observed compared to other groups. But there was no statistical significance. Conclusion: Though the statistically significant difference could not be found, it seemed that there was more new bone and cementum formation with applying biphasic calcium phosphate in 1 wall intrabony defects in dogs by preventing junctional epithelium migration.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.20 no.2
• /
• pp.112-126
• /
• 1998

In dentistry, bony defects can be formed by cyst, tumor, inflammation, trauma and surgery in maxilla and mandible. If the overlying soft tissue invades and preoccupies the jaw bony defects, regenerated bony tissue same as adjacent bone can not replace whole space of the defects, thus preventing osteogenesis from occurring. Guided bone regeneration(GBR) is based on the prevention of overlying soft tissue from entering the bony defect during the initial healing periods. E-polytetrafluoroethylene(e-PTFE) is one of an effective and widely used barrier membrane for GBR, but it has the disadvantages such as surgical removal and high price. To overcome such disadvantages of e-PTFE, many investigators have proposed various absorbable barrier membranes. Inexpensive oxidized cellulose($Surgicel^{(R)}$) membrane was shown to have potential for use as an absorbable barrier membrane for regenerative procedure and it would not require surgical removal. The purpose of this study is to investigate the absorption periods of oxidized cellulose at the implant site and usefulness as a mechanical barrier, preventing the ingrowth of the overlying soft tissue into the bony defects. Two bony defects were made in each tibia of a dog using drill and one defect covered with oxidized cellulose and the other covered with periosteum directly as control. The experimental animals were sacrificed at 1st-7th, 10th, 14th, 21th, 28th day postoperatively, Inspection of the specimens was done to evaluate gross changes. Specimens were examined histopathologically by hematoxylin-eosin and Masson's trichrome staining under light microscope. The results were as follows : 1. There was no significant differences of inflammatory reaction between the experimental and the control group. 2. The resorption of oxidized cellulose was almost completed within 14th day. 3. Histologically, bone formation in the experimental group was somewhat more than that of the control group at 10th, 14th, 21th and 28th day postoperatively. The bone forming pattern of the experimental group was more regular than that of the control group. 4. There was no evidence of soft tissue invasion into the bony defect in the experimental group. In conclusion, oxidized cellulose membrane might be used as an alternative absorbable barrier membrane to prevent overlying soft tissue invasion into the bony defects.

• Journal of Periodontal and Implant Science
• /
• v.37 no.1
• /
• pp.125-136
• /
• 2007

Periodontal regenerative therapy and tissue engineering on defects destructed by severe periodontitis need maintaining of space, which provides the environment for cell migration, proliferation and differentiation. Application of bone grafts may offer this environment in periodontal defects. This study evaluated bone graft materials, $MBCP^{(R)}$ and $Algipore^{(R)}$ , in surgically created i-wall periodontal intrabony defects of minipigs by histological analysis. Critical sized($4mm{\times}4mm$), one wall periodontal intrabony defects were surgically produced at the proximal aspect of mandibular premolars in either right and left jaw quadrants in four minipigs. The control group was treated with debridement alone, and experimental group was treated with debridement and $MBCP^{(R)}$ and $Algipore^{(R)}$ application. The healing processes were histologically observed after 8 weeks and the results were as follows. 1. In the control group, limited new bone formation was observed. 2. In MBCP group, more new bone formation was observed compared to other groups. 3. Histologically, dispersed mixture of new bone, biomaterial particles and connective tissue were shown and osteoblasts, osteoclasts and new vessels were present in this area. 4. Defects with Algipore showed limited new bone formation and biomaterial particles capsulated by connective tissue. 5. Histologically, lots of osteoclasts were observed around the biomaterial but relatively small numbers of osteblasts were shown. Within the limitation to this study protocol, $MBCP^{(R)}$ application in 1-wall intrabony defect enhanced new bone formation rather than $Algipore^{(R)}$ application.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.6
• /
• pp.477-482
• /
• 2011

Introduction: Bone regeneration of cystic defects of the jaws after a cyst treatment requires lengthy healing periods. Generally, the bony changes are observed periodically through a visual radiographic reading as well as by the clinical opinion and radiographic images (panorama, periapical view), but it is difficult to compare the objective bony changes using only the radiographic density. In addition, it is difficult to observe minute bony changes through a visual radiographic reading, which can lead to a subjective judgment. This study exmined the bone density after the enucleation of a jaw cyst by fractal analysis. Materials and Methods: Eighteen patients with a cystic lesion on the jaw were assessed. Panoramic radiographs were taken preoperatively, immediately postoperatively, and 1, 3, 6 and 12 months after cyst enucleation. The images were analyzed by fractal analysis. Results: The mean fractal dimensions increased immediately after surgery and 3, 6 and 12 months postoperatively. The postoperative 6 and 12 months fractal dimension was similar to the controls. Conclusion: Fractal analysis was used to overcome the limit of a subjective reading during an assessment of bone regeneration after cyst enucleation.