• 제목/요약/키워드: Resorbable mesh

검색결과 10건 처리시간 0.028초

Orbital wall restoring surgery with resorbable mesh plate

  • Joo, Jae Doo;Kang, Dong Hee;Kim, Hyon Surk
    • 대한두개안면성형외과학회지
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    • 제19권4호
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    • pp.264-269
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    • 2018
  • Background: Orbital resorbable mesh plates are adequate to use for isolated floor and medial wall fractures with an intact bony buttress, but are not recommended to use for large orbital wall fractures that need load bearing support. The author previously reported an orbital wall restoring surgery that restored the orbital floor to its prior position through the transnasal approach and maintained temporary extraorbital support with a balloon in the maxillary sinus. Extraorbital support could reduce the load applied on the orbital implants in orbital wall restoring surgery and the use of resorbable implants was considered appropriate for the author's orbital wall restoring technique. Methods: A retrospective review was conducted of 31 patients with pure unilateral orbital floor fractures between May 2014 and May 2018. The patients underwent transnasal restoration of the orbital floor through insertion of a resorbable mesh plate and maintenance of temporary balloon support. The surgical results were evaluated by the Hertel scale and a comparison of preoperative and postoperative orbital volume ratio (OVR) values. Results: The OVR decreased significantly, by an average of 6.01% (p<0.05) and the preoperative and postoperative Hertel scale measurements decreased by an average of 0.34 mm with statistical significance (p<0.05). No complications such as buckling or sagging of the implant occurred among the 31 patients. Conclusion: The use of resorbable mesh plate in orbital floor restoration surgery is an effective and safe technique that can reduce implant deformation or complications deriving from the residual permanent implant.

Use of resorbable mesh and fibrin glue for restoration in comminuted fracture of anterior maxillary wall

  • Yang, Jae-Hyuk;Chang, Suk Choo;Shin, Jin Yong;Roh, Si-Gyun;Lee, Nae-Ho
    • 대한두개안면성형외과학회지
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    • 제19권3호
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    • pp.175-180
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    • 2018
  • Background: The facial bone has a complex structure compared to other bones, and various types of fractures can occur due to its characteristics. Among them, in comminuted fractures of anterior maxillary wall, multiple depressed and impacted bony segments cannot be reduced easily when performing internal fixation using plates and screws or wires, and inadequate restoration leads to a range of complications. This paper introduces an alternative technique using a resorbable mesh with fibrin glue to restore comminuted fractures of anterior maxillary wall. Methods: Thirteen patients were diagnosed with comminuted fractures of anterior maxillary wall between March 2017 and February 2018 in the authors' hospital. All patients with comminuted fractures of anterior maxillary wall underwent restoration using resorbable mesh with fibrin glue. The patients' demographics, causes of facial trauma, mean operation time, length of hospital stay, follow-up period, and complications were recorded. Results: No major complications and only one hypoesthesia of the skin area was noted. Three months after surgery, the hypoesthesia recovered completely. After surgery (mean, 3.9 months; range, 2-12 months), computed tomography showed that the bone fragments in all patients were fixed successfully in their anatomical places. Conclusion: In comminuted fractures of anterior maxillary wall, the use of a resorbable mesh with fibrin glue can be an advantageous and effective method for a successful restoration without complications.

Comparative study on long-term stability in mandibular sagittal split ramus osteotomy: hydroxyapatite/poly-ʟ-lactide mesh versus titanium miniplate

  • Park, Young-Wook;Kang, Hyun-Sik;Lee, Jang-Ha
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제41권
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    • pp.8.1-8.6
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    • 2019
  • Background: Resorbable devices have recently been adopted in the field of orthognathic surgery with controversies about their postoperative skeletal stability. Hence, we determined the long-term skeletal stability of unsintered hydroxyapatite/poly-ʟ-lactic acid (HA/PLLA) mesh for osteofixation of mandibular sagittal split ramus osteotomy (SSRO), and compared it with that of titanium miniplate. Methods: Patients were divided into resorbable mesh and titanium miniplate fixation groups. A comparative study of the change in the mandibular position was performed with preoperative, 1-day, 6-month, and 2-year postoperative lateral cephalograms. Results: At postoperative 6 months-compared with postoperative 1 day, point B (supra-mentale) was significantly displaced anteriorly in the titanium-fixation group. Moreover, at postoperative 2 years-compared with postoperative 6 months, point B was significantly displaced inferiorly in the titanium-fixation. However, the HA/PLLA mesh-fixation group did not show any significant change with respect to point B postoperatively. Conclusions: The HA/PLLA mesh-fixation group demonstrated superior long-term skeletal stability with respect to the position of mandible, when compared with the titanium-fixation group.

매식체 주위 열개형 골 결손부의 골 재생시 흡수성 막과 비흡수성 막의 비교 (Comparison of Resorbable and Nonresorbable Membrane for Guided Bone Regeneration in Implant Dehiscence Defects)

  • 권태훈;정진형;임성빈
    • Journal of Periodontal and Implant Science
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    • 제30권2호
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    • pp.323-335
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    • 2000
  • The purpose of this study was to examine the frequency of dehiscence bone defect on peri-implant and to compare the difference between resorbable membrane and nonresorbable membrane in bone regeneration on peri-implant. Amomg the patients, 22 patientswho have recieved an implant surgery at the department of Periodontics in Dankook University Dental Hospital showed implant exposure due to the dehiscence defect and 27 implants of these 22 patients were the target of the treatment. $Gore-Tex^{(R)}$ and $Bio-mesh^{(R)}$ were applied to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 27 cases, 2 membrane exposures were observed and in these two cases, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area $9.25{\pm}4.84$ preoperatively and significantly increased to $11.48{\pm}7.52$ postoperatively.(P<0.05) 4. In resorbable membrane, bone surface area was $14.80{\pm}8.25$ preoperatively and meaningfully widened to $17.61{\pm}10.67$ postoperatively.(P<0.05) 5 . The increase of bone surface area in non-resorbable membrane was $2.23{\pm}3.38$ and the increase of bone surface area in resorbable membrane was $2.80{\pm}3.00$ ;therefore, there was no significant difference between these two membranes(P<0.05). This study implies that the surgical method using DFDB and membrane on peri-implant bone defect is effective in bone regeneration regardless the kind of the membrane, and a similar result was shown when a resorbable membrane was used.

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흡연이 흡수성 차폐막을 이용한 조직유도재생술의 치유에 미치는 영향 (Influence of Smoking on Short-Term Clinical Results of Periodontal Bone Defects Treated with Regenerative Therapy Using Bioabsorbable Membranes)

  • 강태헌;설양조;이용무;계승범;김원경;정종평;한수부
    • Journal of Periodontal and Implant Science
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    • 제30권2호
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    • pp.305-324
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    • 2000
  • This study compared the short-term(4 months) clinical results of regenerative therapy with bioabsorbable membranes($BioMesh^{(R)}$) and bone allograft for the treatment of periodontal(intrabony and furcation) defects in smokers and nonsmokers.(16 smokers) 32 subjects with 92 defects participated in the study(46 in smokers and 46 in non-smokers). This study also evaluated a bioresorbable barrier with and without decalcified freeze-dried bone allograft(DFDBA). The 92 periodontal defects were randomly treated with either the resorbable barrier alone or resorbable barrier in combination with DFDBA following thorough defect debridement and root preparation with tetracycline. Each patient received both types of treatment modalities. Clinical examinations(probing depth, gingival recession, clinical attachment level, plaque index and gingival index) were carried out immediately before and 4 months after surgery. Significant(p<0.001) gains in mean attachment level were observed for both smokers(2.93mm) and non-smokers(3.30mm) but there were not significant difference between two groups. Similarly, significant reductions in mean probing depthshowed for smokers(4.52mm) and non-smokers(4.26mm). However, when comparing gingival recession, smokers were found to exhibit significantly poorer treatment results(1.59mm vs 0.96mm, p<0.05). Using the split-mouth-design, no statistically significant difference between the two modalities could be detected with regard to pocket depth reduction, gingival recession, or attachment gain. These results illustrate that the attachment gain is better in the non-smoker and the best in the non-smoker with the combination therapy of resorbable barrier and DFDBA than with resorbable barrier alone but smoking had no significant effect on clinical treatment outcome, even though smokers show more significant gingival recession. In addition, both treatments, either resorbable barrier plus DFDBA or resorbable barrier alone, promoted significant resolution of periodontal defects but the addition of DFDBA with a bioabsorbable membrane appears to add no extra benefit to the only membrane treatment.

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성견의 외과적 치근이개부 골결손에 차폐막과 골이식재를 이용한 조직유도재생술시 치유양상 (Guided Tissue Regeneration Using Barrier Membrane and Osseous Grafts in Surgically Created Furcation Defects in Dogs)

  • 정은희;정현주
    • Journal of Periodontal and Implant Science
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    • 제26권4호
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    • pp.967-987
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    • 1996
  • The present study was to evaluate the healing patterns of guided tissue regeneration( GTR) using resorbable $Vicryl^{(R)}$(polyglactin 910) mesh and nonresorbable expanded polytetrafluoroethylene(ePTFE) membrane with or without bone grafting using autogeneous bone and demineralized freeze-dried bone allograft(DFDBA) in the grade II furcation defects. Mucoperiosteal flaps were reflected buccally in the mandibular 2nd, 3rd and 4th premolar areas and furcation defects were created surgically by removing $5{\times}6mm$ alveolar bone in 4 dogs. Root surfaces were thoroughly debrided of periodontal ligament and cementum, and notches were placed on root surface at the most apical bone level. In the right and left mandibular quadrant, each tooth was received $Vicryl^{(R)}$ mesh(ACE Surgical Supply Co., USA) only, $Vicryl^{(R)}$ mesh with DFDBA, $Vicryl^{(R)}$ mesh with autogeneous bone grafts, ePTFE membrane($Core-tex^{(R)}$ membrane, W.L. Gore & Associates Inc., USA) only, ePTFE membrane with DFDBA or ePTFE membrane with autogeneous bone grafts. For the fluorescent microscopic examination, fluorescent agents were injected at 2, 4 and 8 weeks after surgery. Four weeks after surgery, 2 dogs were sacrificed and ePTFE membranes were removed from remaining 2 dogs, which were sacrificed at 12 weeks after surgery. Undecalcified tissues were embedded in methylmethacrylate and $10{\mu}m$ thick sections were cut in a buccolingual direction. These sections were stained with hematoxylin-eosin stain and Masson's trichrome stain, and evaluated by descriptive histology and linear measurements. The results were as follows : 1) $Vicryl^{(R)}$ mesh group showed less connective tissue attachment than ePTFE membrane group. 2) The combination of GTR using $Vicryl^{(R)}$ mesh and osseous grafts resulted in new attachment and new bone formation more than GTR using $Vicryl^{(R)}$ mesh only. 3) GTR using ePTFE membrane, with or without osseous grafts, enhanced periodontal regeneration. 4) Root resorption and dentoalveolar ankylosis were observed in the areas treated with the combination of GTR and DFDBA. It was suggested that the effect of adjunctive bone grafting in GTR procedure depends on the materials and the physical properties of barrier membranes. $Vicryl^{(R)}$ mesh performed a barrier function and the use of adjunctive bone grafting may enhance the periodontal regeneration.

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흡수성 차폐막과 동종탈회동결건조골 이식에 의한 치조골 재생의 병용효과 (Alveolar Bone Formation in Dogs using Vicryl Absorbable Mesh(Polyglactin 910) and Decalcified Freeze-Dried Bone Grafting)

  • 오은정;정현주;김영준
    • Journal of Periodontal and Implant Science
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    • 제29권3호
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    • pp.469-484
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    • 1999
  • The purpose of this study was to evaluate new bone formation following guided bone regeneration by resorbable and nonresorbable membrane. Six adult mongrel dogs were used. The first, second, third, fourth premolars in the mandible of each dog were extracted. Two months after tooth extraction, a buccal dehiscence defect was surgically created on each edentulous area. The experimental sites were divided into three groups according to the treatment modalities ; Group I-a: surgical treatment only ; Group I -b: allogenic decalcified freezed dried bone grafting ; Group II-a : e- PTFE membrane placement only ; Group II-b : allogenic decalcified freezed dried bone grafting and e-PTFE membrane placement ; Group III-a : Vicryl(R) mesh placement only ; Group III-b : allogenic decalcified freezed dried bone grafting and Vicryl(R) mesh placement . The animals were sacrificed at 8 weeks after operation and the specimens were prepared for histologic and histometric examination. The results were as follows : Clinically, all defect sites were healed without exposure of barrier membrane after the eight weeks. In Group I-a, dense connective tissues were impinged in the bony defect area. Well vascularized and fibrous bone marrow indicated that bone formation was still taking place was found. In Group I-b, in areas closer to the periphery, lamellation of the newly formed bone would found. In Group II-a, beneath the e-PTFE membrane a dense layer of connective tissue covering the most external portions of the regenerated tissue was seen. The new bone surfaces were lined with osteoid and osteoblast. In Group II-b, a dense layer of connective tissue covering the most external portions of the regenerated tissue was observed beneath the e-PTFE membrane. A notable amount of alveolar ridge regeneration was seen with new rigdes with well-contoured form. In Group III-a, the new bone surface were lined with osteoid and osteoblast, indicating active bone formation. A clear demarcation could not be noted between the host bone and new bone. In Group III-b, a notable amount of alveolar ridge regeneration was seen with new ridges assuming wellcontoured form. In areas closer to the periphery, lamellation of the newly formed bone would found. As histometric examination, the amount of bone formation was gained from $12.8mm^2$ to $26.3mm^2$. It was significantly greater in group II-b and group III-b compared to other groups(p<0.05) . These results suggest that Vicryl(R) mesh after DFDB grafting used in guided bone regeneration could create and sustain sufficient space for new bone formation.

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수종의 흡수성 차단막의 생체 분해도와 조직학적 반응 (Resorbability and histological reaction of bioabsorbable membranes)

  • 석헌주;권석훈;김창성;최성호;전동원;김종관
    • Journal of Periodontal and Implant Science
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    • 제32권4호
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    • pp.781-800
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    • 2002
  • The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. With the development of non-resorbable membrane, GTR has proved to be the representive technique of periodontal regeneration. However, due to various clinical problems of non-resorbable membrane, resorbable membrane was developed and it showed to be clinically effective. The newly developed Para-Dioxanone membrane has a characteristic of non-woven fabric structures which is different from the generally used membranes with structure of mesh form. In addition, Chitosan membrane has been developed to apply its adventage maximally in GTR. Although a number of different types of membranes had been clinically used, researches on absorption rate of membranes were inadequate and limited to subjective opinions. However, since long term period of resorption and space maintenance are required in implant or ridge augmentation, accurate verification of resorption rate is clinically important. In this study, we had implanted Resolut(R), Biomesh(R), Para-Dioxanone membrane and Chitosan membrane (Size : 4mm ${\times}$ 4mm) on dorsal side of Sprague Dawley rat, and sacrified them after 4 weeks, 8 weeks, 12 weeks respectively. Histologic observation was carried out, and the following results were obtained by calculating the objective resorption rate. 1. In case of Resolut(R), external resorption took place initially, followed by internal resorption. Surface area are 5.76${\pm}$2.37$mm^2$, 4.90${\pm}$l.06$mm^2$, 4.90${\pm}$0.98$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.6${\pm}$4.5%, 52.8${\pm}$9.4%, 56.4${\pm}$5.1% respectively. 2. Biomesh(R) showed a pattern of folding, relatively slow resorption rate with small size of membrane. Surface area are 3.62${\pm}$0.82$mm^2$, 3.63${\pm}$0.76$mm^2$, 4.07${\pm}$1.14$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 26.1${\pm}$5.8%, 30.9${\pm}$3.4%, 29.2${\pm}$3.6%, respectively. 3. Para-Dioxanone membrane was surrounded by fibrous conncetive tissue externally, and resorption took place internally and externally. Surface area are 5.96${\pm}$1.05$mm^2$, 4.77${\pm}$10.76$mm^2$, 3.86${\pm}$0.84$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 30.7${\pm}$5.1%, 53.3${\pm}$4.4%, 69.5${\pm}$3.1%, respectively. 4. Each fiber of Chitosan membrane was surrounded by connective tissue and showed external resorption pattern. It showed little invasion of inflammatory cells and excellent biocompatability. The resorption rate was relatively slow. Surface area are 6.01${\pm}$2.01$mm^2$, 5.49${\pm}$1.3$mm^2$, 5.06${\pm}$1.38$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.3${\pm}$3.6%, 38.4${\pm}$3.80%, 39.7${\pm}$5.6%, respectively. Consequently, Para-Dioxanone membrane and Chitosan membrane are found to be clinically effective for their excellent tissue reaction and biocompatibility. Futhermore, the advantage of bone regenerating ability as well as the relatively long resorption period of Chitosan membrane, it might be widely used in implant or ridge augmentation.

내시경과 선택적 도뇨관 풍선을 이용한 안와하벽복원술 (Orbital Floor Reconstruction Using Endoscope and Selected Urethral Balloon Catheter)

  • 최환준;이주철;이형교;김준혁
    • Archives of Plastic Surgery
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    • 제38권1호
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    • pp.35-42
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    • 2011
  • Purpose: Blow-out fractures can be reduced using various methods. The orbital reconstruction technique using a balloon under endoscopic control has advantages over other methods. However, this method has some problems too, such as postoperative follow-up, management of the balloon catheter, and reduction of the posterior orbital floor. Thus, we developed a simple, effective method for orbital floor reduction that involves molding and shaping the antral balloon catheter. Methods: A 0, 30, or $70^{\circ}$, 4-mm endoscope was placed though a two-point, 5-mm maxillary antrostomy. The balloon catheter is placed directly at the orbital apex to reconstruct the anterior shelf (spherical shape), while it is turned in a U-shape towards the anterior maxilla for the posterior shelf (elliptical shape). Orbital floor defects, compound or comminuted fractures are reconstructed with alloplastic materials through an open lid incision under the endoscopic control. Results: This technique was applied to ten patients with orbital floor fractures: five anterior shelf and five posterior shelf fracture, respectively. Four of the patients had zygomatico-orbital fractures, while the rest had isolated orbital floor fractures. Two patients were given porous polyethylene implants Synpor$^{(R)}$) and three underwent reconstruction with a resorbable mesh plate. No complication associated with this technique was identified. Conclusion: The freestyle placement and selection of a urinary balloon catheter under endoscopic control and the preoperative estimation of the volume enhanced the stabilization of the orbital contour. This method improves the adaptation of the orbital floor without the risk of injuring the surrounding orbital contents, dissecting blindly, or using sharp traction. One drawback of this method is the patient's discomfort from the catheter during treatment.

백서의 두개골 결손부에서 탈단백우골 이식 시 흡수성악의 효과 (THE EFFECT OF RESORBABLE MEMBRANE ON BONE REGENERATION IN CALVARIAL DEFECTS OF RATS)

  • 박영준;최근호;장정록;정승곤;김영준;유민기;국민석;오희균;유선열;박홍주
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권5호
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    • pp.365-374
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    • 2009
  • Purpose : This research evaluates the effect of the use of absorbable membrane barrier with deproteinized bovine bone (Bio-$Oss^{(R)}$, Switzerland) on bone healing in surgically created critical-sized defects in rat calvaria. Materials and Methods : Two standardized transosseous circular calvarial defects (5 mm in diameter) are made in each calvarium of 30 rats. These rats are divided into negative control group(n=15), positive control group(n=15) and two experimental groups(n=15). In the negative control group, defects are only filled with blood clots. In the positive control group, defects are filled with autogenous bone obtained from calvarium; in the experimental group 1, defects are filled with deproteinized bovine bone; and in the experimental group 2, defects are filled with deproteinized bovine bone with absorbable membrane. At the postoperative 1 week, 3 weeks. and 6 weeks, clinical. histologic and histomorphometric evaluations of the defects are performed. Results : 1. The grafted bone without membrane in the calvarial bone defect was scattered but, the grafted bone with membrane was stable. 2. $BioMesh^{(R)}$ membrane was absorbed beginning at 3 weeks, and was absorbed considerably at 6 weeks while maintaining the structural form of the membrane. 3. The use of membrane blocked soft tissue invasion. 4. In histomorphometric analysis. it showed the greatest amount of new bone formation in the positive control group. The amount of new bone formation was greater in the experimental group 2 than experimental group 1. At 6 weeks. the amount of new bone formation was greater in the positive control group than experimental group l(p<0.005). Conclusion : These results suggest that membrane increase the stability of grafted bone and protects from soft tissue invasion, and the use of the membrane may promote new bone formation in deproteinized bovine bone graft area.