• Title/Summary/Keyword: Maxillofacial defect

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Comparison of the effects of horizontal and vertical micro-osteoperforations on the biological response and tooth movement in rabbits

  • Kim, Seok-gon;Kook, Yoon-Ah;Lim, Hee Jin;Park, Patrick;Lee, Won;Park, Jae Hyun;Bayome, Mohamed;Kim, Yoonji
    • The korean journal of orthodontics
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    • v.51 no.5
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    • pp.304-312
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    • 2021
  • Objective: This study aimed to compare the amount of tooth movement after multiple horizontal (MH) and single vertical (SV) micro-osteoperforations (MOPs), and evaluate the histological changes after orthodontic force application in rabbits. Methods: The mandibles of 24 white rabbits were subjected to two experimental interventions: MH and SV MOPs. Defect volume of the MOPs between the two groups was kept similar. A force of 100 cN was applied via a coil spring between the incisor teeth and the first premolars. The amount of tooth movement was measured. Differences in the amount of tooth movement and bone variables at three time points and between the two groups were evaluated using repeated-measures analysis of variance. Results: The first premolar showed a mesial movement of 1.47 mm in the MH group and 1.84 mm in the SV group, which was significantly different at Week 3 (p < 0.05). No significant difference was observed in bone volume and bone fraction between the groups. Tartrate-resistant acidic phosphatase-positive cell count was also significantly greater at Week 3 than at Week 1 in both the SV and MH groups. Conclusions: The amount of tooth movement showed significant differences between Weeks 1 and 3 in the SV and MH MOP groups, but showed no differences between the two groups. Therefore, SV MOP could be considered an effective tool for enhancing tooth movement, especially for molar distalization, uprighting, and protraction to an edentulous area.

Prosthetic reconstruction of maxillary defect resulting from a traumatic fall in an elderly patient: A case report (낙상에 의해 상악 전치부에 외상을 입은 노인 환자에서 수술을 배제하고 고정성 보철물을 이용하여 수복한 증례)

  • Bae, Yoonjoo;Choi, Sunyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.1
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    • pp.75-80
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    • 2019
  • Fall is the most common cause of trauma in the elderly and a major reason of dental injury. Maxillary anterior region is the most vulnerable area to the traumatic fall. Loss of teeth and adjacent tissue in this area results in maxillofacial defects and inappropriate maxillomandibular relationship. Reconstruction of the loss requires comprehensive and careful planning to fulfill not only functional but also esthetic demand. Prosthetic approach can avoid surgically extensive intervention, reducing both treatment cost and time. This clinical report describes a 78-year-old woman with the loss of teeth and alveolar bone in maxillary anterior region due to a traumatic fall, rehabilitated with a metal-ceramic fixed dental prosthesis using gingival porcelain.

Symptomatic Temporomandibular Joint Herniation through the Foramen of Huschke: A Case Report

  • Song, Hee-Jeong;Lee, Yuni;Choi, Hang-Moon;Kim, Young-Jun;Kim, Cheul;Park, Moon-Soo
    • Journal of Oral Medicine and Pain
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    • v.46 no.4
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    • pp.161-164
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    • 2021
  • The foramen of Huschke (FH) or foramen tympanicum is a persistent bony defect connecting the external auditory canal (EAC) to the temporomandibular joint (TMJ). It arises from an incomplete ossification of the tympanic part of the temporal bone that persists after the age of 5. If a herniation exists in the TMJ, otological symptoms may occur. An 80-year-old female patient complained of noise in her left TMJ and otorrhea in her left ear. On her cone beam computed tomography images, there were only degenerative joint disease signs on her left mandibular condyle. However, her computed tomography images revealed that the soft tissue of the TMJ herniate into the EAC. Additional examination was planned for the further evaluation. But the patient no longer visited the hospital due to her systemic health status, and symptoms disappeared spontaneously without any treatments. Usually this type of herniation is very rare, but years of mechanical stress from mastication may result in weakening and widening of the foramen with age. Therefore, although FH is usually congenital, sometimes it may be acquired in the elderly. The treatment plan should be determined in consideration of the patient's symptom level and the patient's general health status. If the clinical symptoms are not severe, no treatment is required.

Role of the Gastrocnemius Musculocutaneous with a Propeller Style Skin Flap in Knee Region Reconstruction: Indications and Pitfalls

  • Gianluca Sapino;Rik Osinga;Michele Maruccia;Martino Guiotto;Martin Clauss;Olivier Borens;David Guillier;Pietro Giovanni di Summa
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.593-600
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    • 2023
  • Background Soft tissue reconstruction around the knee area is still an open question, particularly in persistent infections and multiple reoperations scenario. Flap coverage should guarantee jointmobility and protection, even when foreign materials are implanted. The chimeric harvesting of the musculocutaneous gastrocnemius flap, based on the sural artery perforators, can extend its applicability in soft tissue reconstruction of the upper leg, overcoming the drawbacks of the alternative pedicled flaps. Methods A multicenter retrospective study was conducted enrolling patients who underwent to a pedicled, chimeric gastrocnemius musculocutaneous-medial sural artery perforator (GM-MSAP) or lateral sural artery perforator (GM-LSAP) flap for knee coverage in total knee arthroplasty (TKA) recurrent infections and oncological or traumatic defects of the upper leg from 2018 to 2021. Outcomes evaluated were the successful soft tissue reconstruction and flap complications. Surgical timing, reconstruction planning, technique, and rehabilitation protocols were discussed. Results Twenty-one patients were included in the study. Nineteen GM-MSAPs and 2 GM-LSAPs were performed (soft tissue reconstruction in infected TKA [12], in infected hardware [4], and in oncological patients [5]). Donor site was closed primarily in 9 cases, whereas a skin graft was required in 12. Flap wound dehiscence (1), distal flap necrosis (1), distal necrosis of the skin paddle (1), and donor site infection (1) were the encountered complications. Flap reraise associated to implant exchange or extensive debridement was successful without requiring any further flap surgery. Conclusion The propeller-perforator GM-MSAP offers qualitative defect coverage and easiness of multiple flap reraise due to skin availability and its laxity.

The Biological Stability of Immediate Placement of Tapered Implants in Tooth Extraction Sites (발치와에 즉시 식립한 쐐기형 임플란트의 생물학적 안정성에 관한 전향적 연구)

  • Park, Ja-young;Bae, Ahran;Kim, Hyung-Seub;Kwon, Yong-Dae;Lee, Baek-Soo;Kwon, Kung-Rock
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.2
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    • pp.139-155
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    • 2009
  • Objective : To assess the biological stability of immediate transmucosal placement of tapered implants into tooth extraction sockets. Material and methods : Following tooth extraction, tapered implants were immediately placed into the sockets. Teeth with evidence of acute periapical pathology were excluded. After implant placement, sutured allowing a non-submerged, transmucosal healing. Standardized radiographs were obtained every visiting from baseline to 32 weeks after implant placment. Changes in depth of the distance from the implant shoulder (IS) and from the alveolar crest (AC) to the bottom of the defect (BD) were assessed. Results : Thirteen patients (10 males and 3 females) were enrolled and followed. They contributed with 15 tapered implants. extraction iste displayed sufficient residual bone volume to allow primary stability of all implants. The mean surgery time was $41{\pm}10.0$ mins. All implants healed uneventfully yielding a survival rate of 100%. Mean ISQ values were relatively stable. Interproximal crestal bone decreased $1.69{\pm}1.2mm$ (mesial), $1.65{\pm}1.2mm$ (distal) from baseline to 32-week follow-up. No statistically significant changes with respect to FMPS, FMBS, PPD and width of KG were observed. Conclusions: Immediate transmucosal implant placement represented a predictable treatment option for the replacement of teeth lost due to reasons including fractures, endodontic failures and caries.

Clinical application of implant assisted removable partial denture to patient who underwent mandibular resection with oral cancer: A case report (구강암으로 변연골 절제술 시행한 환자를 임플란트 보조 국소의치로 수복한 증례)

  • Yoon, Young-Suk;Han, Dong-Hoo;Kim, Hyung-Joon;Kim, Jee Hwan
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.280-285
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    • 2016
  • Mandible defects could be caused by congenital malformations, trauma, osteomyelitis, tumor resection. If large areas are included for reconstruction, those are primarily due to tumor resection defects. The large jaw defect results in a problem about mastication, swallowing, occlusion and phonetics, and poor esthetics causes a lot of inconvenience in daily life. It is almost impossible to be a part underwent mandibular resection completely reproduced, should be rebuilt artificially. This case is of a patient who was diagnosed with squamous cell carcinoma pT1N0M0, stage I in February 2004 and received surgery (combined mandibulectomy and neck dissection operation (COMMANDO) in oromaxillofacial surgery) in March 2004, by implant assisted removable partial denture. We could obtain good retention and stability through sufficient coverage and implant holding. Follow up period was about four years. Mandibular left third molar regions have been observed to have resorption of surrounding bone, and periodic check-ups are necessary conditions.

Double Processing Obturator for the Hemi-maxillectomy Treated Patient (Hemi-Maxillectomy 환자에서 이중온성법을 이용한 폐색장치의 제작)

  • Hong, Jun-won;Song, Kwang-yeob;Park, Mi-hee;Jeong, Soo-yang;Kim, Kyoung-il;Ahn, Seung-geun;Park, Ju-mi
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.4
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    • pp.329-336
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    • 2009
  • In the case of congenital malformation, acquired trauma, or maxillectomy by neoplasm, the defect in maxilla is combined with nasal cavity, maxillary sinus and oral cavity. This results in abnormal function in pronunciation, mastication, and swallowing. In this situation, the purposes of prosthodontics are also applied. The purposes of obturator for acquired maxillary deficiency patients are restoring pronunciation, mastication, and swallowing, and make patients comfortable and esthetic satisfaction. Reducing weight of the obturator makes edentulous ridge heathy and functional. It also improves patients' comfort. Hollow obturator also reduces unnecessary stress because improves physiologic function, as it weights less than 6.55-33.06% compare to usual one. This case presents the double-processing method for maxillary obturator in the patient treated hemi-maxillectomy due to malignancy neoplasm. We report this case because the patient acquired functional and esthetic satisfaction from double-processing obturator.

A study on the safety and efficacy of bovine bone-derived bone graft material(OCS-B) (생체 유래 골 이식재(OCS-B)의 안전성 및 유효성에 관한 연구)

  • Park, Ho-Nam;Han, Sang-Hyuk;Kim, Kyoung-Hwa;Lee, Sang-Chul;Park, Yoon-Jeong;Lee, Sang-Hoon;Kim, Tae-Il;Seol, Yang-Jo;Ku, Young;Rhyu, In-Chul;Han, Soo-Boo;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.35 no.2
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    • pp.335-343
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    • 2005
  • Inorganic bovine bone mineral has been widely researched as bone substitution materials in orthopedic and oral and maxillofacial application. OCS-B(NIBEC, Korea) is newly-developed inorganic bovine bone mineral. The aim of this study is to evaluate the safety and efficacy of bovine bone-derived bone graft material(OCS-B). Micro-structure of newly-developed inorganic bovine bone mineral(OCS-B) was analyzed by scanning electron microscope(SEM). Round cranial defects with eight mm diameter were made and filled with OCS-B in rabbits. OCS-B was inserted into femoral quadrant muscle in mouse. In scanning electron microscope, OCS-B was equal to natural hydroxyapatite. Rabbits were sacrificed at 2 weeks and 4 weeks after surgery and mice were sacrificed at 1 week and 2 weeks after surgery. Decalcified specimens were prepared and observed by microscope. In calvarial defects, osteoid and new bone were formed in the neighborhood of OCS-B at 2 weeks after surgery. And at 4 weeks after surgery osteoid and new bone bridge formed flourishingly. No inflammatory cells were seen on the surface of OCS-B at 1 week and 2 weeks in mouse experimental group. It is concluded that newly-developed inorganic bovine bone mineral(OCS-B) is a flourishing bone-forming material and biocompatible material.

Restoration of IARPD in partially edentulous patients with bone defects due to osteomyelitis treatment (골수염 치료로 인해 골결함이 있는 부분무치악 환자에서 IARPD 수복)

  • Park, Se-Hyun;Sung, Han-Gyul;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.359-369
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    • 2021
  • Implant prostheses and removable partial dentures are mainly used as treatment methods for partial edentulous patients who have lost a number of teeth. The implant-assisted removable partial denture (IARPD) is strategically selected. The defect in maxillofacial structure due to osteomyelitis, a type of facial bone infection, causes dysfunction such as mastication, swallowing, and pronunciation, as well as social and psychological effects, so a removable restoration is required to restore the supporting tissue. Design of abutment and partial dentures is an essential factor in the success of treatment. In this case, IARPD, which has superior retention and stability compared to traditional removable partial dentures, can have a good prognosis. In a partial edentulous patient with bone defects due to osteomyelitis treatment, the stability of the denture was secured with IARPD restoration. Moreover, maintenance problem that may occur in the future was minimized by providing an appropriate denture design and occlusal scheme through several provisional restorations. This case can be expected to have a favorable prognosis in the long term.

Development of Scaffold for Cell Attachment and Evaluation of Tissue Regeneration Using Stem Cells Seeded Scaffold (세포부착을 위한 스캐폴드 개발 및 줄기세포를 적용한 스캐폴드의 조직재생능력 평가)

  • You, Hoon;Song, Kyung-Ho;Lim, Hyun-Chang;Lee, Jung-Seok;Yun, Jeong-Ho;Seo, Young-Kwon;Jung, Ui-Won;Lee, Yong-Keun;Oh, Nam-Sik;Choi, Seong-Ho
    • Implantology
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    • v.18 no.2
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    • pp.120-138
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    • 2014
  • Purpose: The purpose of this study was to review the outcomes of a series of studies on tissue regeneration conducted in multiple institutions including the Department of Periodontology, College of Dentistry, Yonsei University. Materials and Methods: Studies were performed divided into the following three subjects; 1) Development of three-dimensional nano-hydroxyapatite (n-HA) scaffold for facilitating drug release and cell adhesion. 2) Synergistic effects of bone marrow-derived mesenchymal stem cells (BMMSC) application simultaneously with platelet-rich plasma (PRP) on HA scaffolds. 3) The efficacy of silk scaffolds coated with n-HA. Also, all results were analyzed by subjects. Results: Hollow hydroxyapatite spherical granules were found to be a useful tool for the drug release and avidin-biotin binding system for cell attachment. Also, BMMSC simultaneously with PRP applied in an animal bone defect model was seen to be more synergistic than in the control group. But, the efficacy of periodontal ligament cells and dental pulp cells with silk scaffolds could not be confirmed in the initial phase of bone healing. Conclusion: The ideal combination of three elements of tissue engineering-scaffolds, cells and signaling molecules could be substantiated due to further investigations with the potentials and limitations of the suggested list of studies.