• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.3
• /
• pp.371-377
• /
• 1996

Bone graft has been used to repair one defect caused by disease and trauma, congenital and acquired deformities. Graft materials are autogenous bone, allogenic bone, xenogenic bone, synthetics. Autogenous bone graft is the most superior to other materials for immunologic reaction, compatibility to host tissue, and revascularization. However, autogenous bone graft is required for additional operation and the amount of taking is limited. Autografts are obtained at own expense and also limited in size, shape. In order to compensate these problems, allogenic bone graft has been used increasingly. But allogenic bone graft encounters immunologic complications. Therefore, it has been used after freezing, lyophilization, or demineralization. Allogenic bone processed by only lyophilization includes potential antigenic properties on its surface, therefore it is demineralized to deplete immunologic reaction. Demineralized bone releases BMP and helps the mesenchymal cells transform to the chondroblast to produce cartilage and bone. This reaction is called osteoinducation. Many authors have reported that mineralized lyophilized bone had less antigenicity clinically and favorable bony consideration with host bone. In our department from 1995 to now, we have used banked allogenic bone graft that has been prepared from Wonkwang Bone Bank in 5 cases and mineralized lyophilized bone graft in 2 cases to reconstruct the maxillofacial bone defect after tumor resection and cyst enucleation and cleft alveolus. We will report with literature review that the result is favorable functionally and esthetically.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.5
• /
• pp.264-270
• /
• 2012

Many oral and maxillofacial bone defects are not self-healing. Guided bone regeneration (GBR), which uses a barrier membrane to prevent the soft tissues from invading the defect to enable slower-growing bone cells to penetrate the area, was developed as a therapy in the 1980s. Although there has been some success with GBR in some clinical situations, better treatments are needed. This review discusses the concept of GBR focusing on bioactive membranes that incorporate osteoconductive materials, growth factors and cells for improved oral and maxillofacial bone regeneration.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.19 no.3
• /
• pp.217-231
• /
• 1997

Autogenous bone grafting has a broad range of applications and implications, and also limitations, though it is the oldest and most important reconstructive techniques in the oral and maxillofacial surgical field.Further understanding of bone healing mechanisms, bone physiology and bone biology, transplantation immunology, and development of tissue banking procedures had enabled oral and maxillofacial surgeons to reconstruct even the most difficult bony defects successfully with the preserved allogeneic bone implant. Now autogenous bone and allogeneic bone implants present a wide variety of surgical options to surgeons, whether used separately or in combination. The surgeons are able to make judicious and fruitful choices, only with a through knowledge of the above-mentioned biologic principles and skillful techniques. The author evaluated 116 cases where allogeneic bones were transplanted for oral and maxillofacial reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.14 no.3
• /
• pp.245-253
• /
• 1992

To evaluate the tissue response of demineralized and undimineralized xenogeneic bone-martrix graft in extraskeletal site, we prepared human bone as a implant matrix, and outbred mouse as a recipient. Before clinical application of bank bone of human in Wonkwang university, we should confirm the allogeneic bone grafts us a biologically useful bone graft substitutes, obtanined from the patients receiving oral and maxillofacial surgery. The clinical evaluation and histologic studies showed that both (demineralized and undemineralized) xenogeneic bone matrix grafts were not rejected and that they seemed to stimulate new bone formation at the transplanation site. Undemineralized xenogeneic bone marb6 grafts showed minimal bone induction and gradual demineralization with slow resorption and showed that the differentiation of cells showing fibroblastic activity adjacent to the sop tissue were slowly and less frequently than demineralized bone. Characteristical differences between the demineralized and undemineralized matrix were the appearance of foreign body giant cells (multinucleated giant cells) and the evidence of sloe resorption in undemineralized bone matrix.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.22 no.1
• /
• pp.86-91
• /
• 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
• /
• v.36 no.5
• /
• pp.353-359
• /
• 2010

Introduction: This study examined the effect of cyclosporine A (CsA) on the allogenic cranial bone graft in the mice. Materials and Methods: Twenty eight 12-week-old male ICR mice weighing 40 g were used. The experimental group was injected subcutaneously with CsA (10 mg/kg/day) diluted in Caster oil for 7 days prior to the graft until sacrifice. The control group was injected with the same solution without CsA. Two full-thickness bone defects with a diameter of 3 mm were made with a trephine bur in the parietal bone lateral to the sagittal suture. A calvarial defect of a mouse was grafted with allogenic calvarial bone disc from another mouse. The experimental and control groups were injected with CsA and the solution without CsA in the same manner before surgery, respectively. The mice were sacrificed at 1 week, 2 weeks and 4 weeks after the bone graft, respectively. Results: In the experimental group, fibrous connective tissues and small amounts of inflammatory cells were observed. At 2 weeks after the allograft in the experimental group, new bone formation in fibrous collagenous tissue and around the allogenic bone was noted. At 4 weeks after the allograft, new bone formation was active along and at the periphery of the mature allogenic bone. The proliferation of blood vessels increased in bone marrow. In the control group, fibrous tissues and inflammatory cells were observed around the allogenic bone and existing bone at 1 week. At 2 weeks after the allograft, the proliferation of blood vessels accompanied by inflammatory cells were scattered in the fibrous connective tissues. New bone formation around the allogenic and existing bone could be observed. At 4 weeks after the allograft, inflammatory cells were severely infiltrated around the allogenic bone. Osteoclasts were scattered along the allogenic bone and induced bone resorption. Conclusion: These results suggest that the daily administration of CsA (10 mg/kg/day) induces efficient immunosuppression without serious complications, and this protocol might be useful for the experimental model of allogenic bone grafts.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.17 no.2
• /
• pp.137-152
• /
• 1995

This study was designed to evaluate the bone formation capability of the bone substitute when compared with autogenic bone, freeze-dried demineralized allogeneic bone and bioglass into parietal bone of the rats. We made the parietal bone defects in $7{\times}7mm$ size on rats and has performed the bone graft in each experimental groups. Postoperatively 1, 2, 4, 6, 8, weeks, each specimen stained with H & E, Masson's trichrome methods. We evaluated the osteogensis capability in each groups. The result were as follow : 1. Inflammatory cell infiltration approached at 1 week and disappeared at 4 weeks in all experimental group, expecially severe in freeze-dried demineralized allogeneic bone group. 2. New capillry proliferation was increased in autogeneic bone graft group than any other groups and was increased till 2 weeks and decreased in freeze-dried demineralized allogeneic bone group and was few in bioglass group. 3. Osteoblastic activity increased in autogeneic bone and freeze-dried demineralized allogeneic bone groups till 4 weeks, and decreased in 6 weeks which no difference between these groups. But, few occurred in bioglass group till 6 weeks. 4. Initial osteoclastic activity was prominent in freeze-dried demineralized allogeneic bone group and few in autogeneic bone group. 5. New bone formation bega at 1 week in autograft and freeze-dried demineralized allogenic bone groups, but, mild new bone formation at 8 weeks in bioglass.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.53.1-53.6
• /
• 2019

Background: The nasal bone is the most protruding bony structure of the facial bones. Nasal bone fracture is the most common facial bone fracture. The high rate of incidence of nasal bone fracture emphasizes the need for systematical investigation of epidemiology, surgical techniques, and complications after surgery. The objective of this study is to investigate the current trends in the treatment of nasal bone fractures and the effectiveness of closed reduction depending on the severity of the nasal bone fracture. Patients and methods: A total of 179 patients with a nasal bone fracture from 2009 to 2017 were enrolled. Their clinical examination, patient's records, and radiographic images of nasal bone fractures were evaluated. Results: Patients ranged from children to elderly. There were 156 (87.2%) males and 23 (12.8%) females. Traffic accident (36.9%) was the most common cause of nasal fracture. Orbit fracture (44 patients, 24.6%) was the most common fracture associated with a nasal bone fracture. Complications after surgery included postoperative deformity in 20 (11.2%) patients, nasal obstruction in 11 (6.1%) patients, and olfactory disturbances in 2 (1.1%) patients and patients with more severe nasal bone fractures had higher rates of these complications. Conclusion: Closed reduction could be performed successfully within 2 weeks after injury.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.20 no.4
• /
• pp.275-278
• /
• 1998

Recently, the clinical applications of the autogenous cancellous bone from the proximal tibial metaphysis show satisfactory results in the repair of maxillofacial bony defect or deformity. The proximal tibia has the potential to yield viable cancellous bone with a minimum of morbidity. The purpose of this study was to investigate the regeneration of a full thickness proximal tibial bone defect with covering or uncovering of cortical bone. The follow-up periods were 4, 8, and 12 weeks. Bone defect of right side was uncovered and left side was covered with cortical bone. In the experimental group (uncovered cortical bone) at 12 weeks, the inside of defect was filled to normal marrow tissue. The cortical bone defect was united of inner, outer callus at 4, 8 weeks in both study group. At 12 weeks, the cortical bone defect was remodeled and invaded by osteoclast (giant cell) in experimental group. In the experimental specimen at 12 weeks, the regenerating tissue of bone defect was not differ from the control group.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.14 no.3
• /
• pp.228-236
• /
• 1992

This study was to designed to evaluate the reactions of mouse femoral bone to bone wax. In sixteen mice with a strain of I. C. R. mouse weighed approximately 300 to 850g 2.0~2.0mm sized bone defects were created by drilling. Half of mice were inserted by bone wax and the remainder serving as control without bone wax application. The mice were sacrificed 1, 2, 6, 8 weeks after operation and block specimens were prepared for light microscopy examination. The results obtained were as follows. 1. Histologic features of tissue reaction to bone wax were the presence of inflammatory cell infiltration and multinucleated giant cell. 2. Bone ear healing from the created margin were markedly impaired by the application of bone wax 3. New bone formation was markedly decreased in bone wax application.