• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.185-190
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• 1998

Various local flaps and distant flaps including tongue flap, palatal island flap, and buccal flap as well as skin grafts have been used for the reconstruction of oral mucosal defect. In the posterior region of oral cavity and the buccal cheek area, buccal fat pad can be used as a pedicled graft. The buccal fat pad is different from other subcutaneous fat tissue and it is easily accessible. There are many advantages in pedicled buccal fat pad graft for the closure of oral mucosal defect. The procedure is easy, there is no visible scar in the donor site, it is capable of reconstruction of various contour, and it has good viability. We had used buccal fat pad as a pedicled graft for the closure of oral mucosal defect after the excision of tumor and the oroantral fistula. From the results of these cases, we concluded that the use of the buccal fat pad flaps was worth of the consideration for the reconstruction of oral mucosal defect in the regions of the buccal cheek, and posterior oral cavity.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.1
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• pp.13-20
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• 2009

Background In contrast to defects of the mandible and mouth floor region, in the defect of maxilla, the availability of firmly attached oral and nasal mucosal linings is needed. In addition to it, in consider of operation field, operating convenience, and esthetics, reconstruction using prelaminated flap is strongly recommended. Therefore we consider the prelaminated flap through the cases that is reconstructed using prelaminated forearm flap and prelaminated scapular flap. Patients and Methods From 2001 to 2008, in OMFS SNUDH, there were 6 cases that had reconstruction using prelaminated forearm free flap and other 3 cases that had reconstruction using prelaminated scapular flap of maxilla. The average age of patients that were reconstructed using prelaminated forearm free flap was 47.5 years, the average prelaminated period (after $1^{st}$ operation ${\sim}$ until $2^{nd}$ operation) was 51.8 days and the average follow-up period after $2^{nd}$ operation was 35.3 months. As well, the average age of patients that were reconstructed using prelaminated scapular free flap was 37 years, the average prelaminated period (after $1^{st}$ operation ${\sim}$ until $2^{nd}$ operation) was 57 days and the average follow-up period after $2^{nd}$ operation was 42.3 months. Results Except 1 case that were reconstructed using prelaminated scapular flap, we could get firmly attached oral and nasal stable skin(mucosal like) lining, more adequate thickness flap than any other flap and improved esthetic and functional results in the other 8 cases that were reconstructed using prelaminated flap. The complications of the prelaminated forearm flap cases were inconvenient swallowing, sputum, limitation of mouth opening and difficult mastication. It came from flap shrinkage of the flap in some aspect, as well as other combined operations such as mass resection or RND. The difficult point of the reconstruction of prelaminated scapular flap was the possibility of vascular damage at preparation of flap in $2^{nd}$ surgery. The damage could cause the failure of the prelaminated scapular flap. And the skin-lining of the prelaminated flap had limitations, so it is needed to study about the cultured oral epithelium-lining flap instead of the skin-lining flap. Conclusion We considered about advantages, complications and notable things of prelaminated flap through maxillary reconstruction cases using prelaminated forearm flap and prelaminated scapular flap so far. Furthermore, we should go on studying for functional reconstruction of prelaminated fasciomucosal flap using cultured oral epithelium.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.527-537
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• 2007

To evaluate criteria, indications, and prognosis of the various reconstructive methods on the patients with intraoral soft tissue defect who had been treated at Dept. of Oral and Maxillofacial Surgery, Pusan National University Hospital from 2003 to 2005, we have reviewed the clinical data of the patients and analysed. The results were as follows: 1. Tongue flaps have been mainly applied on anterior portion of palate and maxilla. The survival rate was high percent, but the cooperation of patient was inevitable for the success. 2. Palatal mucosa rotational flaps were available on relative large defect on palate, oroantral fistula site. The side effect was a scaring band from secondary healing on denuded donor palate site. Sometimes the band came to be a hinderance to swallowing, phonation. 3. Forearm free flap was a workhorse flap for everywhere in intraoral defects. We had used the flap on cheek, floor of mouth, tongue without any significant complications. But the application of the flap was required for long operation time, which was disadvantageous to the old, weak patients. 4. Cervical platysmal flap could be easily applicable for buccal cheek, floor of mouth after excision of the cancer lesion. The design of the flap could be made simultaneously on neck dissection, but the danger of cancer remnants on the flap always might be remained. 5. Buccal fat pad pedicled flap must have been a primary flap for repair of oroantral fistula especially on posterior maxilla. The flap survival will be expected if the considerations for above reconstructive methods on site, size, condition of defects primarily could be made.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.8.1-8.8
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• 2017

Background: For an effective bone graft for reconstruction of the maxillofacial region, an adequate vascular network will be required to supply blood, osteoprogenitor cells, and growth factors. We previously reported that the secretomes of bone marrow-derived mesenchymal stem cells (MSC-CM) contain numerous growth factors such as insulin-like growth factor (IGF)-1, transforming growth factor $(TGF)-{\beta}1$, and vascular endothelial growth factor (VEGF), which can affect the cellular characteristics and behavior of regenerating bone cells. We hypothesized that angiogenesis is an important step for bone regeneration, and VEGF is one of the crucial factors in MSC-CM that would enhance its osteogenic potential. In the present study, we focused on VEGF in MSC-CM and evaluated the angiogenic and osteogenic potentials of MSC-CM for bone regeneration. Methods: Cytokines in MSC-CM were measured by enzyme-linked immunosorbent assay (ELISA). Human umbilical vein endothelial cells (HUVECs) were cultured with MSC-CM or MSC-CM with anti-VEGF antibody (MSC-CM + anti-VEGF) for neutralization, and tube formation was evaluated. For the evaluation of bone and blood vessel formation with micro-computed tomography (micro-CT) and for the histological and immunohistochemical analyses, a rat calvarial bone defect model was used. Results: The concentrations of IGF-1, VEGF, and $TGF-{\beta}1$ in MSC-CM were $1515.6{\pm}211.8pg/mL$, $465.8{\pm}108.8pg/mL$, and $339.8{\pm}14.4pg/mL$, respectively. Tube formation of HUVECs, bone formation, and blood vessel formation were increased in the MSC-CM group but decreased in the MSC-CM + anti-VEGF group. Histological findings suggested that new bone formation in the entire defect was observed in the MSC-CM group although it was decreased in the MSC-CM + anti-VEGF group. Immunohistochemistry indicated that angiogenesis and migration of endogenous stem cells were much more abundant in the MSC-CM group than in the MSC-CM + anti-VEGF group. Conclusions: VEGF is considered a crucial factor in MSC-CM, and MSC-CM is proposed to be an adequate therapeutic agent for bone regeneration with angiogenesis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.363-367
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• 2011

Genioplasy with osteotomy is a flexible and useful procedure. However, osteotomy can cause different types of morbidity. Chin augmentation with porous polyethylene ($Medpor^{(R)}$) has become popular in the recent years. Porous polyethylene ($Medpor^{(R)}$) is an excellent biomaterial for reconstructing facial deformities. $Medpor^{(R)}$ has a porous architecture, which prevents capsule formation and decreases the degree of foreign-body reaction. In addition, it can be easily cut with scissors and molded, and it also maintains its shape. We report here on a satisfactory case of chin augmentation with using porous polyethylene ($Medpor^{(R)}$).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.1
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• pp.47-50
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• 2021

Untreated adult or elderly cleft lip and palate patients are rarely seen, but studies on delayed primary palatal closure have been performed in the less developed Asian and African countries, where access to medical care is difficult. A 64-year-old woman visited our clinic with untreated cleft palate with a 40×20-mm-wide defect in the medial palate. Two-flap palatoplasty under general anesthesia was performed to close the cleft palate. After 1 month, the result was favorable without any complications including oronasal fistula. Cleft palate primary repair in an elderly patient is rare and has some surgical problems that are associated with a wide range of defects, but good results can be obtained if surgery is performed well with appropriate considerations.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.4
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• pp.303-312
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• 2007

Recently several studies have been developed not only to apply bone materials to bony defect, but also to use osteogenic and osteoinductive materials to form bone more effectively. In 1998 Mark et al applied gel formation of PRP(platelet-rich plasma) in bony transplantation for mandibular reconstruction as one of the method of stimulating bone formation in maxillofacial area, which is contain of varies growth factors. After he reported that PRP accelerate bone formation, which is used in varies bone transplantation and augmentation with a good result. Especially there are amount of growth factors in PRP, and PRP increase angiogenesis, cell division, and mesenchymal cell growth. Moreover it is capable of osteoconduction, hemostatitis, anti-infection, forming the shape at transplantation, ease of handling, and recipient site stability. So it is known that success rate is high in bone transplantation. However PRP need tissue adhesive to make plasma to solid form. Thrombin and calcium chloride, component of PRP, is extracted from autogenic donor. So it is expensive to extract and there is possibility of hepatitis, AIDS, and hematogenous metastasis. After all, tissue adhesive have the limitation and danger of use. So we are willing to introduce that we had get some idea after using PRF(platelet-rich fibrin) in the various hard and soft tissue bony defect, which is self extracted simply and contain growth factors.

• Imaging Science in Dentistry
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• v.37 no.4
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• pp.221-223
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• 2007

The radiographic diagnosis of typical Stafne bone cavity could be done easily with cyst-like round or oval radiolucency near the angle of the mandible, under mandibular canal with or without involving mandibular base, and no symptoms. However there are some atypical cases suggesting possible variations of this entity. We report a quite unusual case, where Stafne bone cavity was lastly included in the differential diagnosis list. Histological examination of salivary gland tissues confirmed the final diagnosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.2
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• pp.191-194
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• 1995

We describe here a method of approaching the maxillary sinus using an osteoperiosteal flap. Like the Caldwell-Luc procedure, the method allows an easy access to the sinus and an adequate visualization. But in addition, it appears to have the advantages of preventing the ingrowth of soft tissue through the osseous defect into the sinus by replacing the bone trap door while promoting healing and retarding infection by preserving the blood supply to the door.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.3
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• pp.87-91
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• 1990

This is to report a case of secondary reconstruction after partial mandibulectomy by using of marrow-cancellous bone and cortical bone harvested from the iliac crest in the case of an ameloblastoma on the mandible. According to the past experimental studies, the marrow and cancellous bone have the marked osteogenic potential of hematopoietic. And the cortical bone has the highest activity of bone induction, which is mediated through the action of bone morphogenic protein(BMP). This grafting technique, the combination of PMCB and cortical bone, has advantage in restoring lange defect of the mandible.