• Title/Summary/Keyword: Sequestrectomy

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Regenerative effect of recombinant human bone morphogenetic protein-2/absorbable collagen sponge (rhBMP-2/ACS) after sequestrectomy of medication-related osteonecrosis of the jaw (MRONJ)

  • Min, Song-Hee;Kang, No-Eul;Song, Seung-Il;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.3
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    • pp.191-196
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    • 2020
  • Objectives: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein-2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement properties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. Materials and Methods: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after sequestrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. Results: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann-Whitney U-test, P<0.05). Conclusion: Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.

Osteomyelitis in an Osteopathia Striata with Cranial Sclerosis Patient

  • Park, Heung-Chul;Kim, Hang-Gul;Kim, Yong-Hwan;Kim, Joo-Hwan;Kim, Moon-Young;Kim, Kyung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.6
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    • pp.285-291
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    • 2014
  • Osteopathia striata with cranial sclerosis (OS-CS) is characterized by linear bone dysplasia at the long bone radiographically and sclerotic change at the cranium. The purpose of this case report is to study the symptoms and treatments of osteomyelitis in a patient with OS-CS. A 41-year-old patient had pus discharge from a fistula at the mental region and increase in radiolucencies with sequestra in panoramic radiograph images. Computed tomography (CT) as well as radiograph images for the whole skeleton were taken. The patient was diagnosed with OS-CS. Sequestrectomy and fistulectomy were performed. The patient recovered and no relapse occurred within six months after surgery. For diagnosis of OS-CS, CT and additional radiograph images for the whole skeleton are required. Because of the increased bone density, this patient is prone to relapse after sequestrectomy. Therefore, the surgeon must minimize trauma with the least incision and exfoliation, and preoperative antibiotics.

A CASE REPORT OF OSTEOMYELITIS OF THE MANDIBLE DUE TO MISUSAGE OF THE ARSENIC COMPOUND (아비산제제 오용으로 인한 악골골수염 치험례 보고)

  • Kim, Su-Nam;Lee, Hu-Seung;Sim, Gwang-Seop
    • The Journal of the Korean dental association
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    • v.13 no.6
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    • pp.559-562
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    • 1975
  • This is a case of the patient, a 15 -year-old girl, presented a marked necrotic osteomyelitis due to misusage of the arsenic compound for devitaliaztion of the lower right 2nd molar in the right posterior part of the mandible. She was obtained good satisfactory results by sequestrectomy of necrotic bone and by removing of lower right 2nd molar and unerupted 3rd molar tooth germ.

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Case Report of Necrotic Osteomyelitis of Mandibular Molar Areas Due to Misusage of the Arsenic Compound (아비산제제의 오용으로 인한 하악 대구치부위에 발생한 골수염 치험례)

  • Choie, Mok-Kyun;Lee, Bong-Won;Kim, Jin-Ho
    • The Journal of the Korean dental association
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    • v.17 no.1 s.116
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    • pp.53-57
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    • 1979
  • This is a case of the patient, a 30-year-old woman, presented a necrotic osteomyelitis due to misusage of the arsenic trioxide for devitalization of the lower left first and second molars. She was obtained good satisfactory results by sequestrectomy of necrotic bone.

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LIMITED OR LE FORT I DOWN FRACTURE ACCESS FOR WIDESPREAD OSTEOMYELITIS OF MAXILLA (광범위한 상악골 골수염의 제한적 접근법과 Le Fort I 하방 골절을 통한 접근법)

  • Go, Taek-Su;Lee, Won;Kim, In-Soo;Cha, Hyun-Suk;Han, Hyung-Uck;Seo, Woon-Kyung;Park, Su-Hyun;Yun, Kyoung-In
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.5
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    • pp.436-439
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    • 2005
  • Purpose: To compare the case of widespread maxillary osteomyelitis treated through different approach. Method: We report the two case of osteomyelitis. In a case, we had gradually removed the small amount of sequestrum for several times. In the other case, intended Le Fort I fracture was done to approach the lesion. Result: In the gradual sequestrectomy case, bone formations were found after 4 months. In the other case, after intended Le Fort I down fracture, sequestrectomy of Lt. maxilla was done with the labiobuccal alveolar bone preserved for the prosthodontic treatment.

TREATMENTS OF COMMINUTED MANDIBULAR FRACTURES (하악골 분쇄골절의 치료)

  • Jeon, Woo-Jin;Kim, Su-Gwan;Kim, Hyeon-Ho;Kim, Hak-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.1
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    • pp.71-75
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    • 2005
  • This study evaluated retrospectively the treatment method and postoperative complications of communited mandibular fractures. We analyzed the clinical and radiologic data of 14 patients with the comminuted mandibular fractures who were admitted to Chosun University Dental Hospital from January 1998 to December 2003. We reviewed the cause of trauma, fracture sites, treatment methods, and postoperative complications. Thirteen patients (93%) had a successful treatment outcome without complications. Only one patient developed postoperative osteomyelitis requiring early plate removal and sequestrectomy. For the comminuted fractures of mandible, internal fixation using micro- or mini-plate was an effective treatment method with a low incidence of major complications.

Treatment of osteomyelitis in the rear area of the lingula of the mandible using sagittal split ramus osteotomy: a case report

  • Jung, Tae-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.4
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    • pp.203-207
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    • 2015
  • Osteomyelitis is classified into three groups according to its origin: osteomyelitis that originates from the blood supply, osteomyelitis related to bone disease or vascular disease, and osteomyelitis related to a local infection of dental or non-dental origin. The present case involved osteomyelitis related to a local infection of dental origin and was located in the rear area of the lingula of the mandible. We decided to use sagittal split ramus osteotomy to access the osteomyelitis area. Under general anesthesia, we successfully performed surgical sequestrectomy and curettage via sagittal split ramus osteotomy.

Extralobar Pulmonary Sequestration -A cases Report- (외엽형 폐격리증 1례 보고)

  • 홍종완
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.793-796
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    • 1988
  • Pulmonary sequestration is an unusual congenital malformation characterized by the presence of nonfunctioning lung tissue which usually has no communication with the normal bronchial tree and receives its blood supply from an anomalous systemic artery. We present a case of extralobar pulmonary sequestration experienced recently. The patient was 13 month old female with a complaint of fever, coughing and tachypnea. Chest film showed large homogeneous opacity in left lower lung field. At operation, a homogeneous mass was located between the left upper lobe and lower lobe, measuring 4X6X5cm in dimension. The aberrant artery was originated from the descending thoracic aorta, 1 cm in length and 3 mm in diameter. After division and ligation of the aberrant artery, sequestrectomy and lingular segmentectomy was done due to abscess formation. The postoperative course was smooth. She was discharged on postoperative thirteenth day.

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Extralobar Supradiaphragmatic Pulmonary Sequestration Arising from the Retroperitoneum Through a Congenital Diaphragmatic Defect

  • Lee, Soojin;Cho, Jeong Su;I, Hoseok;Ahn, Hyo Yeong;Kim, Yeong Dae
    • Journal of Chest Surgery
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    • v.54 no.3
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    • pp.224-227
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    • 2021
  • Here, we report the rare case of a 13-year-old girl with a congenital diaphragmatic hernia (also known as Bochdalek hernia), which was revealed to be an extralobar pulmonary sequestration that was treated using laparoscopic and video-assisted thoracic surgery sequestrectomy and repair of the diaphragm defect after detection of a supradiaphragmatic mass connected with the retroperitoneum. The patient showed no postoperative complications at a 1-month follow-up examination.

Free Muscle Transplantation of the Chronic Lower Extremity Osteomyelitis (만성 하지 골수염에 시행한 유리 근 이식술)

  • Lee, Jun-Mo;Huh, Dal-Young
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.176-183
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    • 1999
  • Chronic osteomyelitis have been treated with wound dressing and antibiotics therapy often results in healing but foul odor pus discharges from the fibrotic soft tissues reactivates and requires appropriate control of the infection. Debridement of the wound, curettage and sequestrectomy, bone graft and immediate free flap transplantation is the curative protocol for the chronic osteomyelitis in the lower extremity. Authors have treated 7 cases of chronic osteomyelitis in the lower extremity with microsurgical free tissue transplantation at Department of Orthopedic Surgery, Chonbuk National University Hospital from December 1993 through February 1998. The results are as follows. 1. The chronic osteomyelitis occurred in tibial shaft in 4 cases, in calcaneus 2 cases and in femur 1 case. 2. Duration of the chronic osteomyelitis was at average 31.6 years. 3. Squamous cell carcinoma in the surrounding fibrotic tissue was biopsied in 1 case. 4. 4 cases had no trauma and occurred through hematogenous infection and 3 cases had fracture trauma. 5. Wound debridement and immediate free muscle transplantation had done in 5 cases and wound debridement, sequestrectomy and immediate free muscle transplantation in 2 cases. 6. Rectus abdominis muscle transplantation had peformed in 4 cases(57.1%), latissimus dorsi mucle 1 case(14.3%), latissimus dorsi myocutaneous 1 case(14.3%) and gracilis 1 case (14.3%). 6 cases of 7 were success(85.7%). 7. 1 case of failed latissimus dorsi musculocutaneous flap in thigh had done above knee amputation and 1 case of chronic posttraumatic osteoarthritis of the ankle joint had done below knee amputation at other hospital.

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