• Title/Summary/Keyword: Maxillofacial defect

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The Use of Bilateral Buccal Mucosal Flap for the Repair of Bilateral Cleft Alveolus : 2 Case Reports (양측성 치조열의 재건을 위한 협부 점막피판의 사용:2증례)

  • Kim Nam-Hun;Song Min-Seok;Kim Hyeon-Min;Jung Jung-Hui;Eom Min-Yong;Koo Hyun-Mo;Yi Jun-Kyu
    • Korean Journal of Cleft Lip And Palate
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    • v.8 no.1
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    • pp.31-37
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    • 2005
  • In alveolar deformity of cleft patient, the flap design is very important to make the functional and esthetic outcome. Especially in bilateral cleft alveolus with wide defect, deficiency of covering tissue is a greatest problem. Wound dehiscence may develop oronasal fistula of palatal and labial region and loss of the bone graft. We report 2 cases with bilateral cleft alveolus. In both case, bilateral buccal mucosal flap was used for closure of bilateral cleft alveolus with wide defect. The one was operated with iliac bone graft according to secondary grafting method, the other was closed without bone grafting. The patient was 3 years old. So, secondary alveolar bone graft will be required some years later for the establishment of bony continuity and esthetic advantage. In both cases, we found the entire soft tissue closure without the lack of covering flap. In these case, the closure of alveolus defect was accomplished successfully by the use of bilateral buccal mucosal flap. There was no complication, secondary fistula. The most important thing is the tension-free closure of the bilateral buccal mucosal flap. So, we report these cases with literatures.

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Radiographic evaluation of the zygomatic air cell defect

  • Park Young-Hee;Lee Soo-Kyung;Park Byeong-Hyun;Son Hyo-Sun;Choi Mi;Choi Karp-Shik;An Chang-Hyeon
    • Imaging Science in Dentistry
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    • v.32 no.4
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    • pp.207-211
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    • 2002
  • Purpose : The purpose of this study was to determine the prevalence, radiographic appearance, and characteristics of patients with zygomatic air cell defect (ZACD), and to give recommendations concerning radiographic evaluation and surgery. Materials and Methods: Routine panoramic radiographs of 1,400 patients admitted to the Kyungpook National University Hospital Dental Clinic, were retrospectively examined for the clinical and radiographic features of ZACD. Results: ZACD was found in 31 cases, representing a prevalence of 2.2%. Patients with ZACD had a mean age of 27.5 years and a range of 9-52 years. Most ZACD cases were in their thirties. ZACD showed a strong male prediliction, 22 of the 31 subjects were males and 9 were females. Twenty-four cases of ZACD (77.4%) were unilateral, with the half occurring on the right side. In seven cases (22.6%), ZACD was bilateral. Twenty-six (68.4%) of the defects were of unilocular, while twelve (31.6%) of the defects were multilocular. Conclusion: Knowledge of ZACD may be helpful in interpreting images, including panoramic radiographs, in planning surgical treatment of the TMJ and in understanding the spread of pathological processes into the joint.

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EFFECT OF HEPATOCYTE GROWTH FACTOR ON THE REPAIR OF DEFECT IN THE ARTICULAR DISC IN RABBIT TEMPOROMANDIBULAR JOINT (가토의 측두하악관절원판 결손에서 간세포 성장인자가 치유에 미치는 영향)

  • Kim, Bok-Joo;Seong, Hwa-Sik;Kim, Chul-Hoon;Kim, Gyoo-Cheon;Hwang, Hee-Sung;Shin, Sang-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.1
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    • pp.1-7
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    • 2009
  • Purpose: The purpose of this study is to investigate the therapeutic use of Hepatocyte growth factor(Adv.CMV.HGF) in temporomandibular joint disc defect. Materials and methods: Twelve New Zealand white rabbits, weighing 2.5 - 3.0 kg, were used in this experiment. Defects(2 mm in diameter) were created in their TMJ discs. Recombinant Adv.CMV.HGF with gelatin sponge($Gelfoam^{(R)}$) as carrier was implanted in the defects. We divided the rabbits into four batches according to the duration of the implantation - of 1, 4, 8, 12 weeks - and both left and right TMJ of each rabbit in all groups were used in the research : left joints were used as experiment group and right were control group. Each batch of rabbits was killed one, four, eight and twelve weeks after the experimentation respectively, and called Group A, B, C, and D. (Group A = 1 wk, B = 4 wks, C = 8 wks, and D = 12 wks) Results: The experimental group showed a significant increase in the number of chondroblasts and active cell differentiation at the margin of the defects. Compared to the control group, in the experiment group chondroblasts increased and chondrocytes showed a columnar arrangement, which is witnessed at the time of cell differentiation. Conclusion: This study supports the case that Avd.CMV.HGF may be useful in the repair of articular disc of the rabbit TMJ.

Closure of radial forearm free flap donor-site defect with proportional local full-thickness skin graft: case series study of a new design

  • Han, Yoon-Sic;Lee, Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.6
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    • pp.427-431
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    • 2021
  • Objectives: The aim of this study was to describe a simple, convenient, and reliable new technique using local full-thickness skin graft (FTSG) for skin coverage of a donor-site defect of the radial forearm free flap (RFFF). Patients and Methods: Between April 2016 and April 2021, five patients with oral squamous cell carcinoma underwent mass resection combined with RFFF reconstruction. After RFFF harvesting, donor-site defects were restored by proportional local FTSG. Results: The donor-site defects ranged in size from 24 to 41.25 cm2, with a mean of 33.05 cm2. Good or acceptable esthetic outcomes were obtained in all five patients. There was no dehiscence, skin necrosis, wound infection, or severe scarring at the graft site through the end of the postoperative follow-up period, and no patient had any specific functional complaint. Conclusion: The proportional local FTSG showed promising results for skin coverage of the donor-site defect of the RFFF. This technique could decrease the need for skin grafts from other sites.

Deep circumflex iliac artery free flap in the mandibular reconstruction (DCIA를 이용한 하악골 재건술)

  • Won, Ji-Hoon;Kim, Bong-Chul;Kim, Hyung-Jun
    • The Journal of the Korean dental association
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    • v.49 no.9
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    • pp.520-526
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    • 2011
  • Vascularized iliac crest flap include bone tissue of good quality and quantity for mandible segmental defect. Even if fibular flap can contain longer bone tissue, iliac crest has esthetic shape for mandible body reconstruction and large height for implant. Conventional vascularized iliac crest osteomyocutaneous flap is too bulky for reconstruction of intraoral soft tissue defect. But modified flap can reduce soft tissue volume, so is good for functional reconstruction of oral mucosa. It takes only one month for completely replace oral mucosa. The final mucosal texture is much better than other skin paddle flap, especially for implant prosthesis. Donor site morbidity of this method looks same level or less with other modalities functionally and socially. In case of oral mucosa-mandible combined defect, vascularized iliac crest with internal oblique muscle flap shows good outcomes for hard and soft tissue.

Developmental salivary gland defect : Literatures review and case analysis of 12 cases (발육성 타액선 골 결손의 문헌 고찰 및 증례 분석)

  • Kim Hak-Kyun;Kim Jin-Soo;Kim Jae-Duk
    • Imaging Science in Dentistry
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    • v.36 no.2
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    • pp.81-88
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    • 2006
  • Purpose : To review developmental salivary gland defect based on 12 reported cases and literature, and to guide radiographic diagnosis of this entity. Materials and Methods : The 12 cases of developmental salivary gland defect of Chosun University Dental Hospital in the last 4 years were analyzed and compared with previous reported cases. Result : 11 of the 12 cases were found in men, indicating a very strong male predilection. The peak age was in the 6th decade. These defects were situated just above or at the inferior border of mandible between the first molar and the mandibular angle, and always Inferior to the mandibular canal. Only one case was superimposed with the mandibular canal, 6 cases were superimposed with the inferior border of the mandible. Conclusion : Characteristically, these defects had a special radiographic features such as ovoid shaped well-defined radiolucency located just above or at the inferior border of the mandible between the first molar and the mandibular angle, and always inferior to the mandibular canal. The recognition of these radiographic features were diagnostically valuable.

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Evaluation of canalis basilaris medianus using cone-beam computed tomography

  • Syed, Ali Z.;Zahedpasha, Samir;Rathore, Sonali A.;Mupparapu, Mel
    • Imaging Science in Dentistry
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    • v.46 no.2
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    • pp.141-144
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    • 2016
  • The aim of this report is to present two cases of canalis basilaris medianus as identified on cone-beam computed tomography (CBCT) in the base of the skull. The CBCT data sets were sent for radiographic consultation. In both cases, multi-planar views revealed an osseous defect in the base of the skull in the clivus region, the sagittal view showed a unilateral, well-defined, non-corticated, track-like low-attenuation osseous defect in the clivus. The appearance of the defect was highly reminiscent of a fracture of the clivus. The borders of osseous defect were smooth, and no other radiographic signs suggestive of osteolytic destructive processes were noted. Based on the overall radiographic examination, a radiographic impression of canalis basilaris medianus was made. Canalis basilaris medianus is a rare anatomical variant and is generally observed on the clivus. Due to its potential association with meningitis, it should be recognized and reported to avoid potential complications.

AN EXPERIMENTAL STUDY ON THE HEALING PROCESS AFTER THE IMPLANTATION OF VARIOUS BONE SUBSTITUTES IN THE RATS (백서에서 수종의 골대체재료 매식후 치유과정에 관한 실험적 연구)

  • Kim, Young-Kyun;Kim, Su-Gwan;Lee, Jun-Gil;Lee, Mi-Hyang;Cho, Jae-O
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.1
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    • pp.15-24
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    • 2001
  • The purpose of this study is to evaluate the tissue response in applying of various bone substitutes included toothash-plaster mixture, resorbable hydroxylapatite (HA) and demineralized freeze-dried bone and to show the clinical usefulness of toothash-plaster mixture for the repair of craniomaxillofacial bone defect. For this experiment, 100 Sprague-Dawley rats weighing 200gm or more were used. There were four experimental groups: group I, toothash-plaster mixture; group II, demineralized freeze-dried bone; group III, resorbable HA; and group IV, control group. A full thickness, round bone defect measuring 10mm in diameter was created in the midcranium, and the substitutes cited above were embedded in the experimental rats based on their group assignment. Blood clot was filled in the rats assigned to the control group. Experimental rats were sacrificed on the 1st, 3rd, 5th, 8th, 12th and 24th week after implantation and stained with the hematoxylineosin, Masson's Trichrome, using Van Gieson's stain method, and were examined under light microscope. The results were as follows: 1. In all the groups, prominent inflammatory reaction and the infiltration of multinucleated giant cells were noted during the early stage. Gradual healing decreased this reaction. 2. Among the rats in the experimental group II, which were given demineralized freeze-dried bone implants, active formation of new bone traveculae manifested. Chondroid tissues appeared, and it was suggested that the defect was filled with newly formed bone by virtue of osteoinductive activity. On the 12th week after the experiments, most of the defect was filled with newly formed bone trabeculae. 3. In experimental groups I and III, it was noted that HA manifested a healing process similar to that characterized by the toothash-plaster mixture, but inflammatory reaction was more prominent in experimental group I. Active osteoblasts were observed along the periphery of osteoid tissues, while newly formed bone trabeculae appeared adjacent to the implanted materials three weeks later. Formation increased to the extent that newly formed bone trabeculae fused directly with the host bone. Increase in new bone ingrowth into the filling materials was revealed by both experimental groups. 4. In the control group, new bone formation adjacent to the host bone was observed, but most of the defect was filled with mature connective tissue 24 weeks after the experiments.

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ANALYSIS OF PROSTHODONTIC AND SURGICAL TREATMENT OF ACQUIRED PALATAL DEFECT AFTER MAXILLECTOMY (상악절제술 후 외과적 재건과 보철적 치료의 비교)

  • Kwon, Ho-Beom;Hong, Jong-Rak
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.143-151
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    • 2007
  • One of the treatment methods for maxillary cancers or infections in maxilla is maxillectomy. Palatal defect can be resulted from this operation and it may cause functional problems with swallowing and speech, and psychological problems of patients. After maxillectomy, as rehabilitation, there can be two options. One is a prosthodontic treatment using obturator and the other is surgical reconstruction of defect with graft. As both methods have advantages and disadvantages, in determining treatment method after maxillectomy, various factors have to be considered. The purpose of this study is to compare the prosthodontic group to surgical group after maxillectomy with elapsed days prior to commencement of postoperative oral feeding, and to analyze the results of prosthodontic treatment and surgical treatment. During the period from March of 2000 to June of 2006, 74 patients were treatment by prosthodontic methods for maxillary defect. Among these patients, patients who had only velopharyngeal deficiency after surgery, whose data were incomplete, whose causes of palatal defect were not the treatment of diseases in maxilla, and who already had palatal defect due to previous surgery were excluded in this study. The patients who underwent maxillectomy for the treatment of diseases in the maxilla and were treated immediately after operation using surgical reconstruction or prosthodontic rehabilitation were included in this study. The records of 43 patients were reviewed to compare and to analyze the prosthodontic treatment and surgical reconstruction after maxillectomy. The median of days elapsed prior to commencement of postoperative oral feeding in the prosthodontic group was compared with data of surgical group. The data was analyzed using the Mann-Whitney test (${\alpha}$=.05). Days elapsed prior to postoperative oral feeding commencement in the prosthodontic group were less than those in the surgical group.

The Effect of Aloe, Gelfoam, Plaster on Bone Formation in Applying to the Bone Defect (Aloe, Gelfoam, Plaster가 골결손부의 신생골 형성에 미치는 영향에 관한 실험적 연구)

  • Choi Eui-Hwan;Kim Su-Gwan
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.29 no.2
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    • pp.493-505
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    • 1999
  • Purpose: This study was to evaluate the effects of Aloe. Gelfoam. and Plaster of Paris on bone healing. Materials and Methods: Four experimental defects were created for placement of the three materials in the right femur of dogs. One defect served as an empty control site. The evaluation was performed at 1-. 6-. and 12-weeks by light microscopy and radiographs. Results: Radiographic and histologic examinations showed new bone formation in the presence of Aloe, Gelfoam. and Plaster of Paris and similar bone healing reactions. Conclusion: On the basis of these findings, it was concluded that Aloe, Gelfoam. and Plaster of Paris may be adequate agents for use in bone procurement.

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