• 제목/요약/키워드: Maxillofacial defect

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Walk-Up flap을 이용한 악안면 영역의 결손부 재건 (Walk-Up flap for Reconstruction of Oral and Maxillofacial defects)

  • 신상훈;박성진;이광호;이성근
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권2호
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    • pp.249-253
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    • 2000
  • Oral and Maxillofacial defects is produced by trauma or cancer surgery. This defects have been shown functional loss such as mastication, swallowing, speech and psychosocial esthetic problem. Oral and Maxillofacial defects is reconstructed by the use of many flaps. However although previous flap surgery was done, additional soft tissue defects can be still remained. In this case, Walk-Up flap that is introduced by Marx RE in 1990 is recommended for successful reconstruction. We report Walk-Up flap for reconstruction of remained soft tissue defects of tongue S.C.C. After induction chemotherapy, tongue S.C.C. is excised surgically and reconstructed by use of PMMC flap. Post-op infection results in surrounding soft tissue defect with oro-facial fistula. We have experienced a case of Walk-up flap by use of PMMC flap for reconstruction with satisfactory result, so we report it with literature reviews.

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Reconstruction of Defect after Treatment of Bisphosphonate-related Osteonecrois of the Jaw with Staged Iliac Bone Graft

  • Ahn, Kyo-Jin;Kim, Young-Kyun;Yun, Pil-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제36권2호
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    • pp.57-61
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    • 2014
  • Bisphosphonate is used widely for osteoporosis treatment, but a rising concern is the risk of osteonecrosis after long-term bisphosphonate use. Such cases are increasing, suggesting a need for research to prevent and treat bisphosphonate-related osteonecrosis of jaws. A 63-year-old female took bisphosphonate (Fosamax$^{(R)}$) for four years for treatment of osteoporosis and stopped medication two months ago because of unhealed wound. She was treated with marginal mandibulectomy maintaining the inferior border, and a metal plate was placed to prevent mandible fracture. Four months after the mandibulectomy, mandible reconstruction surgery using iliac bone and allograft was done. Six months after reconstruction, implant placement and treatment with an overdenture was done without complications. This study presents a case with a successful result.

Micro-titanium mesh를 이용한 안와저 골절의 외과적 처치에 대한 연구 (TREATMENT OF THE 'BLOW-OUT' FRACTURE USING MICRO-TITANIUM MESH)

  • 김성곤;전영두;윤경인
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제21권3호
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    • pp.312-316
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    • 1999
  • When the external force was applied to the orbit the most thin area might be displaced. These were usually orbital floor and/or medial wall of orbit. Among these cases some who showed the entrapment of the muscle between the fractured fragments needed the surgical treatment. We had operated 4 cases of the "blow-out" fracture via subciliary approach. The entrapped muscles were freed from fragments and the bony defect was restored with micro-titanium mesh. Mean follow-up periods was 15 months and there were no complication observed.

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협점막판을 이용한 외상성 상순 결손부의 외과적 재건 (Reconstruction of Avulsed Upper Lip with Buccal Mucosal Flap)

  • 양동규;김종렬;최갑림
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제11권1호
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    • pp.283-286
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    • 1989
  • The buccal mucosa is an effevtive and versatile intraoral grafting material. For adequate reconst ruction of avulsed lip, restoration of natural appearance and adequate lip function should be done. We treated avulsed upper lip defect which had been affected underlying orbicularis oris muscle as well as vermilion border. We chose cheek mucosa for upper lip reconstruction and performed surgical correction of avulsed upper lip with pedicled buccal mucosal flap. The result was very good because of its superior color and texture matching to remaining yermilion tissue.

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Herniation after deep circumflex iliac artery flap: two cases of rare complication

  • Kim, Hee-Sung;Kim, Jae-Young;Hur, Hyuk;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제38권
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    • pp.10.1-10.5
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    • 2016
  • Herniation after harvesting of deep circumflex iliac artery (DCIA) flap is a known but not a common complication. It occurs about 2.8 to 9 % according to the literatures and can proceed to a more severe complication such as bowel obstruction. There are several factors that exacerbate the risk: surgical factors, operator factor, and patient factors. Surgical factors include large anatomical defect and denervation of related muscles. Operator factor stands for unpunctual suture technique. Patient factors represent obesity, diabetes, pulmonary disease, smoking habits, and so on. Thus, herniation might occur regardless of meticulous suture. Herein, we would like to report two cases of herniation after DCIA flap harvesting and repaired by Lichtenstein tension-free hernioplasty with literature review.

치아회분과 석고 혼합매식물 이식에 관한 임상적 연구;장기간 추적 연구 (THE CLINICAL STUDY OF IMPLANTATION OF TOOTHASH COMBINED WITH PLASTER OF PARIS;LONG-TERM FOLLOW UP STUDY)

  • 김수관;여환호;김영균
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권4호
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    • pp.771-777
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    • 1996
  • This study was undertaken to access the effect of toothash combined with plaster of Paris in the filling of jaw defect and the substitution as new bone during the follow up period. We used the toothash and plaster after the cyst enucleation, the apicoectomy, the extraction of supenumerary tooth with ratio of 2 : 1 by weigh. 15 consecutive patients were evaluated retrospectively. Complications were swelling, perforation, infection and treated without problems using incision & drainage, aspiration, antibiotic treatment, 2ndary buccal flap. The follow-up period ranged from 28 to 35 months. Based on radiographic and clinical observation, it may be concluded that toothash and dental plaster of Paris($CaSo_4\;{\cdot}\;1/2H_2O$) are useful for bone substitute.

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Repair of an oroantral communication by a human amniotic membrane: a novel technique

  • Lakshmi, Subha;Bharani, Siva;Ambardar, Kalhan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권4호
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    • pp.194-197
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    • 2015
  • The amniotic membrane is the innermost layer of fetal membrane and is attached to the chorion in the placenta. This membrane has been used for nearly a century in varied fields such as ophthalmology, reconstructive surgery, and burn treatment. In this case report, we used a human amniotic membrane to repair an iatrogenic oroantral communication that occurred during the extraction of the patient's right upper second molar. A splint was given after the perforation was covered with human amniotic membrane and healing was clinically evaluated at various intervals. The outcome of the study revealed that the human amniotic membrane was an efficient graft material for repairing the defect caused by an iatrogenic oroantral communication following tooth extraction.

Condylar jugular diverticulum: A report of 3 cases

  • Jagtap, Rohan;Wazzan, Taggreed;Hansen, Matthew;Kashtwari, Deeba
    • Imaging Science in Dentistry
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    • 제49권3호
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    • pp.251-256
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    • 2019
  • Jugular bulb diverticulum is an irregular extension of the jugular bulb into the temporal bone that may be symptomatic or asymptomatic. The jugular bulb has rarely been reported to extend into the occipital condyle; such extension is termed a condylar jugular diverticulum and is characterized as a defect in the occipital condyle contiguous with the jugular bulb. This report details 3 cases of condylar jugular diverticulum. Extension of the jugular bulb into the ipsilateral occipital condyle was noted as an incidental finding on cone-beam computed tomographic (CBCT) images of 3 patients. All 3 patients were asymptomatic, and this finding was unrelated to the initial area of interest. CBCT use is becoming ubiquitous in dentistry, as it allows 3-dimensional evaluation, unlike conventional radiography. Proper interpretation of the entire CBCT is essential, and recognition of the indicators of condylar jugular diverticulum may prevent misdiagnosis of this rare entity.

3-Dimensional Micro-Computed Tomography Study on Bone Regeneration with Silk Fibroin, rh-Bone Morphogenetic Protein Loaded-Silk Fibroin and Tricalcium Phosphate Coated-Silk Fibroin in Rat Calvaria Defect

  • Pang, Eun-O;Park, Young-Ju;Park, Su-Hyun;Kang, Eung-Sun;Kweon, Hae-Yong;Kim, Soeng-Gon;Ko, Chang-Yong;Kim, Han-Sung;Nam, Jeong-Hun;Ahn, Jang-Hun;Chun, Ji-Hyun;Lee, Byeong-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권1호
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    • pp.1-11
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    • 2012
  • Purpose: The purpose of this study was to evaluate the bone regeneration capacity of silk fibroin (SF) when combined with beta tricalcium phosphate (${\beta}$-tricalcium phosphate [TCP]) and rh-bone morphogenetic protein (BMP) in vivo by micro-computed tomography (CT), soft x-ray, and histological analysis. Methods: A total of 56 critical size defects formed by a trephine bur made on 28 adult female Spague-Dawley rats were used for this study and the defect size was 5.0 mm in diameter. The defects were transplanted with (1) no graft material (raw defect), (2) autogenous bone, (3) SF ($10{\mu}g$), (4) SF-BMP ($10{\mu}g$, $0.8{\mu}g$ each), and (5) SF+${\beta}$-TCP ($10{\mu}g$). At 4 and 8 weeks after operation, the experimental animals were sacrificed. Samples were evaluated with soft x-ray, histological examinations and 3-dimensional micro-CT analysis. Results: In the 3-dimensional micro-CT evaluation, bone volume and bone surface data were higher in the SF-BMP ($12.8{\pm}1.5$, $138.6{\pm}45.0$ each) (P<0.05) and SF-TCP ($12.3{\pm}1.5$, $144.9{\pm}30.9$ each) group than in the SF group ($6.1{\pm}3.3$, $77.2{\pm}37.3$ each) (P<0.05), except for the autogenous group ($15.0{\pm}3.0$, $190.7{\pm}41.4$ each) at 4 weeks. At 8 weeks, SF-BMP ($16.8{\pm}3.5$, $173.9{\pm}34.2$ each) still revealed higher (P<0.05) bone volum and surface, but SF-TCP ($11.3{\pm}1.5$, $1132.9{\pm}52.1$ each) (P=0.5, P=0.2) revealed the same or lower amount compared with the SF group ($13.8{\pm}2.7$, $127.5{\pm}44.8$ each). The % of bone area determined by radiodensity was higher in the SF-TCP ($31.4{\pm}9.1%$) and SF-BMP ($36.2{\pm}16.2%$) groups than in the SF ($19.0{\pm}10.4$) group at the period of 4 weeks. Also, in the histological evaluation, the SF-BMP group revealed lower inflammation reaction, lower foreign body reaction and higher bone healing than the SF group at postoperative 4 weeks and 8 weeks. The SF-TCP group revealed lower inflammation at 4 weeks, but accordingly, as the TCP membrane was absorbed, inflammatory and foreign body reaction are increased at 8 weeks. Conclusion: The current study provides evidence that the silk fibrin can be used as an effective grafted material for tissue engineering bone generation through a combination of growth factor or surface treatment.

유리골 이식을 통한 하악골 결손부의 기능적 재건술 (FUNCTIONAL RECONSTRUCTION OF MANDIBULAR DEFECTS WITH FREE BONE GRAFT)

  • 김종원;남일우;김명진;정필훈;서병무;유준영;남기원;송민석
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제15권4호
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    • pp.338-345
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    • 1993
  • 양성 종양, 악성 종양, 감염, 외상 등에 의한 하악골 결손은 중대한 심미적, 생물학적 결과를 일으킨다. 재건술의 일차적 목적은 완전한 기능 회복이며 이는 이차적으로 심미적 변형의 정상화를 유도한다. 저자들은 1981년에서 1990년까지 서울대학교 치과대학 구강 악안면외과에 내원하여 하악골 재건술을 시행받고 6개월 이상 추적조사가 가능한 61증례의 임상적 자료 및 방사선 검사를 통해 부위별 임상적 성공률을 조사하였다. 본 임상 논문의 목적은 하악골 결손부위와 부위에 따른 유리골 이식의 성공률을 연구하는데 그 의의를 두겠다. 유리골 이식의 임상적 연구를 요약해 보면 유리 자가골 이식의 대부분은 장골이었고 망상피질골이었다. 6개월 이상 추적조사가 가능한 61명의 환자에 있어 전체적 성공률은 80.3% 였다. 강선고정과 구외접근법이 다른 방법보다 그 예후에 있어 훨씬 더 좋은 결과를 나타냈고 다른 부위보다 하악 정중부위가 그 예후에 있어 훨씬 나쁜 결과를 보였다.

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