• Title/Summary/Keyword: Oral defect

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THE RECONSTRUCTION OF THE MAXILLARY WALL DEFECT USING MICRO-TITANIUM MESH (Micro-titanium mesh를 이용한 상악골 결손부의 재건술에 관한 연구)

  • Kim, Seong-Gon;Choi, You-Sung;Choung, Pill-Hoon;Lee, Hee-Chul
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.197-203
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    • 2000
  • Maxillary defect may be induced by trauma, inflammation, cyst, tumor and surgical procedure. In case of limited wall defect, free bone graft has been preferred. But it has some problems such as postoperative bone resorption and soft tissue inclusion to recipient site. And we can not use free bone in the case who has inflammation in the donor site. So we used the micro-titanium mesh as reconstructive material for the maxillary wall defect. We had operated 8 patients who were diagnosed as maxillary partial defects from June 1997 to September 1998 in the Chin-Hae military hospital. They were 1 case of antral wall defect, 1 case of palatal wall defect, 5 cases of infra-orbital wall defects and 1 case of oroantral fistula case. As a result, the micro-titanium mesh has shown the morphological stability and biocompatibility and it could be used in case who has infection. And mesh structure could prevent soft tissue ingrowth to bony defect area. Thus it can be used to the case of maxillary partial defect successfully.

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AN EXPERIMENTAL STUDY ON THE BONE REGENERATION OF TIBIAL BONE DEFECT (경골 이식의 골결손부 골재생에 대한 실험적 연구)

  • Kim, Su-Gwan;Yeo, Hwan-Ho;Kim, Soo-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.275-278
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    • 1998
  • Recently, the clinical applications of the autogenous cancellous bone from the proximal tibial metaphysis show satisfactory results in the repair of maxillofacial bony defect or deformity. The proximal tibia has the potential to yield viable cancellous bone with a minimum of morbidity. The purpose of this study was to investigate the regeneration of a full thickness proximal tibial bone defect with covering or uncovering of cortical bone. The follow-up periods were 4, 8, and 12 weeks. Bone defect of right side was uncovered and left side was covered with cortical bone. In the experimental group (uncovered cortical bone) at 12 weeks, the inside of defect was filled to normal marrow tissue. The cortical bone defect was united of inner, outer callus at 4, 8 weeks in both study group. At 12 weeks, the cortical bone defect was remodeled and invaded by osteoclast (giant cell) in experimental group. In the experimental specimen at 12 weeks, the regenerating tissue of bone defect was not differ from the control group.

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CLINICAL STUDY ON TIBIAL BONE GRAFT (경골이식에 관한 임상 연구)

  • Kim, Sik;Kim, Su-Gwan;Kim, So-Young;Kim, Soo-Min;Park, In-Soon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.540-543
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    • 2000
  • The purpose of this retrospective study was to evaluate the treatment outcome of proximal tibial graft. Thirty-nine patients were grafted with proximal tibia for the repair of maxillofacial defect. Complications can be considered incidental and neglectable clinical significance. It is concluded that the proximal tibial metaphysis offers a promising alternative sources of cancellous bone for the repair of maxillofacial defect.

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Periapical multilocular osteoporotic bone marrow defect

  • Jung Yun-Hoa;Cho Bong-Hae;Nah Kyung-Soo
    • Imaging Science in Dentistry
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    • v.35 no.4
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    • pp.221-223
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    • 2005
  • A case of osteoporotic bone marrow defect, which appeared as a well-defined multilocular radiolucency overlapping the roots of mandibular right second molar, was reported. On periapical radiograph, a daughter cyst-like radiolucency was seen at the anterior margin of the lesion making it difficult to rule out odontogenic keratocyst.

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Reconstruction plates used in the surgery for mandibular discontinuity defect

  • Seol, Guk-Jin;Jeon, Eun-Gyu;Lee, Jong-Sung;Choi, So-Young;Kim, Jin-Wook;Kwon, Tae-Geon;Paeng, Jun-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.6
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    • pp.266-271
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    • 2014
  • Objectives: The purpose of this study was to analyze the survival rate of reconstruction plates that were used to correct mandibular discontinuity defects. Materials and Methods: We analyzed clinical and radiological data of 36 patients. Only discontinuous mandibular defect cases were included in the study. Reconstruction plate survival rate was analyzed according to age, gender, location of defect, defect size, and whether the patient underwent a bone graft procedure, coronoidectomy, and/or postoperative radiation therapy (RT). Results: Plate-related complications developed in 8 patients, 7 of which underwent plate removal. No significant differences were found in plate survival rate according to age, gender, location of defect, defect size, or whether a bone graft procedure was performed. However, there were differences in the plate survival rate that depended on whether the patient underwent coronoidectomy or postoperative RT. In the early stages ($9.25{\pm}5.10months$), plate fracture was the most common complication, but in the later stages ($35.75{\pm}17.00months$), screw loosening was the most common complication. Conclusion: It is important to establish the time-related risk of complications such as plate fracture or screw loosening. Coronoidectomy should be considered in most cases to prevent complications. Postoperative RT can affect the survival rate and hazard rate after a reconstruction plate is fitted.

FUNCTIONAL RECONSTRUCTION OF DENTO-PALATAL AND MAXILLARY DEFECT USING STAGED OPERATION OF PREFABRICATED SCAPULAR FREE FLAP AND DENTAL IMPLANTS (분층피부와 분말골로 이식 전 처리된 유리견갑골근피판과 임플란트 보철을 이용한 경구개와 상악골의 기능적 재건)

  • Lee, Jong-Ho;Kim, Myung-Jin;Park, Jong-Chul;Kim, Yung-Soo;Ahn, Kang-Min;Paeng, Jun-Young;Kim, Sung-Min;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Choung, Pill-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.4
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    • pp.301-307
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    • 2004
  • The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

Effect of rhBMP-2 on the healing of bone defect in the low calcium diet rat (rhBMP-2가 저칼슘식이 투여 백서의 골결손부 치유에 미치는 영향)

  • Choi Yong-Suk;Hwang Eui-Hwan;Lee Sang-Rae
    • Imaging Science in Dentistry
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    • v.34 no.1
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    • pp.35-48
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    • 2004
  • Purpose: To investigate the effect of rhBMP-2 on the healing of bone defect in the low calcium diet rat. Materials and Methods: To prepare the experimental model, control group was fed a normal diet and experimental group was fed a low calcium diet for 3 weeks. And then, 4 mm bicortical perforated bone defect was made on mandibular body of each rats. Experimental group was subdivided into two groups; experimental group 1 (rats given a low calcium diet before and after bone defect) and experimental group 2 (rats given a low calcium diet before and after bone defect with rhBMP-2 application). At 1, 3, 5 and 7 weeks after bone defect formation, the rats were terminated. The healing of bone defect was assessed by three-dimensional computerized tomography, soft x-ray radiography, and histopathological examination. Results : The wound healing of the bone defect for control group, experimental group 1, and experimental group 2 showed a increase from 3 weeks after bone defect formation. The experimental group 2 showed a more increase in healing amount than control group and experimental group 1 from 5 weeks after bone defect formation and the experimental group 2 showed a complete recovery of bone defect at 7 weeks after bone defect formation. Conclusion: The healing process of bone defect is accelerated by rhBMP-2 application in the low calcium diet rats.

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Multilocular developmental salivary gland defect

  • Kim, Jin-Soo
    • Imaging Science in Dentistry
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    • v.42 no.4
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    • pp.261-263
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    • 2012
  • Developmental salivary gland defect is a bone depression on the lingual surface of the mandible containing salivary gland or fatty soft tissue. The most common location is within the submandibular gland fossa and often close to the inferior border of the mandible. This defect is asymptomatic and generally discovered only incidentally during radiographic examination of the area. This defect also appears as a well-defined, corticated, unilocular radiolucency below the mandibular canal. Although it is not uncommon for this defect to appear as a round or ovoid radiolucency, multilocular radiolucency of these defects is relatively rare. This report presents a case of a developmental salivary gland defect with multilocular radiolucency in a male patient.

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.

Reconstruction of cheek mucosal defect with a buccal fat pad flap in a squamous cell carcinoma patient: a case report and literature review

  • Hwang, Dae-Seok;Park, Jinyoung;Kim, Uk-Kyu;Park, Hae-Ryoun;Kim, Gyoo-Cheon;Ryu, Mi-Heon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.11.1-11.5
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    • 2018
  • Background: Squamous cell carcinoma (SCC) is the most commonly occurring malignant tumor in the oral cavity. In South Korea, it occurs most frequently in the mandible, tongue, maxilla, buccal mucosa, other areas of the oral cavity, and lips. Radial forearm free flap (RFFF) is the most widely used reconstruction method for the buccal mucosal defect. The scar of the forearm donor, however, is highly visible and unsightly, and a secondary surgical site is needed when such technique is applied. For these reasons, buccal fat pad (BFP) flap has been commonly used for closing post-surgical excision sites since the recent decades because of its reliability, ease of harvest, and low complication rate. Case presentation: In the case reported herein, BFP flap was used to reconstruct a cheek mucosal defect after excision. The defect was completely covered by the BFP flap, without any complications. Conclusion: Discussed herein is the usefulness of BFP flap for the repair of the cheek mucosal defect. Also, further studies are needed to determine the possibility of using BFP flap when the defect is deep, and the maximum volume that can be harvested considering the changes in volume with age.