• Title/Summary/Keyword: Maxillofacial defect

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THE HISTOLOGICAL AND IMMUNOHISTOCHEMICAL FINDINGS OF THE NEWLY FORMED HUMAN BONE AFTER DISTRACTION OSTEOGENESIS (하악골 신연술 후 생성된 신생골의 조직학적 및 면역화학적 소견)

  • Yun, Kyoung-In;Park, Je-Uk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.258-262
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    • 2001
  • Distraction osteogenesis(DO) can be performed in the bony defect associated with trauma, anomaly, and various kinds of disease. The gap generated by DO is filled with growing callus : during the period of distraction, the osteogenesis is continued. However, there have been few reports about expression pattern of growth factors in newly formed bone during the consolidation periods. We performed DO in the mandibular defect case and studied the expressed pattern of growth factors. Its pattern was compared to that of the same patient. BMP-2 and -4 were strongly expressed in the DO site. Particularly, BMP-4 was not expressed in the normal mature bone, but expressed in new bone in DO. However, there was no difference in the FGF-7 expression between the sites. Therefore, strong expression of BMP-4 are related to new bone formation in DO and they may not be related to the normal homeostasis in human bone. Though FGF-7 is related to the growth of keratinocyte, it may have minimal role in the DO and normal mature bone.

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APPLICATION OF ARTIFICIAL DERMIS($Terudermis^{(R)}$) AND SPLIT THICKNESS SKIN GRAFT ON THE DONOR SITE OF RADIAL FOREARM FLAP (인공진피($Terudermis^{(R)}$)와 부분층 피부이식을 이용한 전완피판 공여부 수복)

  • Oh, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.227-232
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    • 2007
  • The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

DEVELOPMENT OF MOLDABLE BONE REGENERATING THERAPEUTICS USING PARTIALLY PURIFIED PORCINE BONE MORPHOGENETIC PROTEIN AND BIORESORBABLE POLYMER (Poly(L-lactide)와 돼지골기질에서 추출 부분정제한 골형성단백을 이용한 조형가능성 골형성유도체의 개발)

  • Lee, Jong-Ho;Chung, Chong-Pyung;Lee, Sung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.179-185
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    • 2000
  • The purpose of this study was to develop an osteogenic, biodegradable material using polymer and BMP. It was designed to have structural function and be moldable, for the reconstruction of load bearing areas and deformities of various configurations. Bone apatite was added to Poly(L-lactide)(PLLA) and made porous for osteoconductability and ease of BMP loading. The materials, with or without BMP purified from porcine bone matrix, were evaluated in cranial bone defect models in rats for biocompatibility and bone regeneration capability. The following results were obtained: The PLLA-BMP material with BMP added to the polymer showed 30% healing of cranial bone defects in rats during the 2 weeks to 3 months period of observation. The moldable PLLA agent without BMP also showed 25% bone healing capacity. Although new bone formation was incomplete in the critical size defect of rat cranium, it can be concluded that the unique moldability of those agents makes them useful for the reconstruction of various bone defects and maxillofacial deformities.

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USAGE OF NASOLABIAL SKIN FLAPS FOR THE RECONSTRUCTION OF VARIOUS INTRAORAL DEFECTS (다양한 구강내 결손부 재건을 위한 비순피판의 활용)

  • Kim, Kyoung-Won;Lee, Eun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.1
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    • pp.71-78
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    • 2007
  • The nasolabial flap has been used for reconstruction of moderate size intraoral defects. The nasolabial fold area provides an ample supply of tissue with a good color and texture match. The nasolabial flap classified advancement flap, inferiorly-based flap, superiorly-based flap. The flap is based inferiorly, so that it can easily be rotated to the intraoral defects. The nasolabial flap is chosen for the repair of various intraoral defects because of its simple elevation, proximity to the defect and its rich subcutaneous blood supply of a island flap. The subjects were 6 patients with nasolabial flap, who had reconstruction of moderate size intraoral defects. We have found the inferiorly-based nasolabial flap with a subcutaneous pedicle useful in the primary repair of surgical defects of the buccal mucosa, edentulous mandibular ridge, maxillary alveolus area and soft palate in these patients. There was no complication except one case. Intraoral hair growth was a minor problem of this patient. We thought that the inferiorly-based nasolabial flap is a useful technique for reconstruction of various intraoral defects.

A STUDY OF THE EFFECT OF CULTURED BONE MARROW STROMAL CELLS ON PERIPHERAL NERVE REGENERATION (체외 배양한 골수줄기세포를 이용한 말초신경재생에 관한 연구)

  • Choi, Byung-Ho;Zhu, Shi-Jiang;Jung, Jae-Hyung;Huh, Jin-Young;Lee, Seoung-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.6
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    • pp.492-495
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    • 2005
  • The role of cultured bone marrow stromal cells (BMSCs) in peripheral nerve regeneration was examined using an established rabbit peroneal nerve regeneration model. A 15-mm peroneal nerve defect was bridged with a vein filled with BMSCs $(1{\times}10^6)$, which had been embedded in collagen gel. On the contralateral side, the defect was bridged with a vein filled with collagen gel alone. When the regenerated tissue was examined 4, 8 and 12 weeks after grafting, the number and diameter of the myelinated fibers in the side with the BMSCs were significantly higher than in the control side without the BMSCs. This demonstrates the potential of using cultured BMSCs in peripheral nerve regeneration.

CASE REPORTS OF CONGENITAL DUPLICATED MAXILLA (선천성 상악골 중복기형의 치험례)

  • Lee, Beak-Soo;Choi, Hyun-Jung;Ryu, Dong-Mok;Oh, Jung-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.5
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    • pp.434-437
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    • 2004
  • Neural crest cells have embriologically important role for the development and growth in oral and maxillofacial region. If the early hereditary defect occurs or environmental factors affect these cells diminutive mesenchymal cells are disabled to make neural plate and decreased proliferation of mesenchymal cells result in hypoplastic development of neural crest. As a result, this brings about severe facial malformations such as various located facial clefts and/or loss or duplication of facial structure. These are two cases of accessory maxilla and zygomatic deformity with and without facial cleft.

RECONSTRUCTION OF ORAL AND MAXILLOFACIAL DEFECTS USING TEMPORAL MUSCLE FLAP (구강악안면 영역에서의 측두근판(temporal muscle flap)을 이용한 재건술)

  • Bae, Chan-Yong;Hwang, Soon-Jung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.69-73
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    • 2002
  • Temporal muscle flap is usefull for the reconstruction of tissue defect at the oral and maxillofacial area. This article reports 3 cases of temporal muscle flap for the soft tissue reconstruction of infraorbital, palatal and mandibular retromolar area after tumor ablation. The advantages and disadvantage, postoperative complications and technical variations were reviewed and our 3 cases were evaluated in this aspects.

Biomaterial development for oral and maxillofacial bone regeneration

  • Sulzer, Lindsay S. Karfeld;Weber, Franz E.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.5
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    • pp.264-270
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    • 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.

THE EFFECT OF HEPATOCYTE GROWTH FACTOR FOR REPAIR OF THE BONE DEFECT (간세포성장인자가 골결손부의 치유에 미치는 영향)

  • Shin, Sang-Hun;Kim, Chang-Ju;Kim, Cheol-Hun;Kim, Yong-Deok;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.5
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    • pp.380-390
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    • 2004
  • Bone healing plays an important role in orthognathic and craniofacial surgery. Bone tissue repair and regeneration are regulated by an array of growth and morphogenetic factors. Bone formation and remodeling require continuous generation of osteoprogenitor cells from bone marrow stromal cells, which generate and respond to a variety of growth factors with putative roles in hematopoiesis and mesenchymal differentiation. In this study, the efficacy of a single application of hepatocyte growth factor to promote bone regeneration in 5-mm experimental calvarial defects of adult male rats was assessed histologically and immunohistochemically. The result of the experimental site were compared with those of the contralateral contral side. None of the control and experimental bone defects demonstrated complete bone closure. Bone regeneration was found close th the margine and central part of the defects. At 1, 2 weeks, there were found much significant cellural mitotic activity and many inflammatory cells and osteoblasts on the experimental site than control site. At 4, 6 weeks, new bone apposition was founded in both site but, more apposition was seen at experimental site. At 8, 12 weeks, also, some differences was found that more apposition of new bone and collagen fiber was seen on experimental site. Our results have some possibility that HGF do a early positive role to repair the bone defect. More study will be needed.