• Journal of Periodontal and Implant Science
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• 제52권4호
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• pp.325-337
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• 2022

Purpose: The aim of this study was to investigate the effect of (1) the size of the bony access window and (2) collagen membrane coverage over the window in sinus floor elevation in a rabbit sinus model. Methods: Small bony access windows (SW; ø 2.8 mm) were made in 6 rabbits and large windows (LW; ø 6 mm) in 6 other rabbits. Both sinuses in each rabbit were allocated to groups with or without coverage of a collagen membrane (CM) on the window, resulting in 4 groups: SW, LW, SW+CM, and LW+CM. After 4 weeks of healing, micro-computed tomographic, histologic, and histomorphometric analyses were performed. Results: Bony healing in the window area was incomplete in all groups, but most bone graft particles were well confined in the augmented cavity. Histologically, the pattern of new bone formation was similar in all groups. Histomorphometrically, the percentage of newly formed bone was greater in the groups with CM than in the groups without CM, and in the groups with SW than in the groups with LW (12.92%±6.40% in the SW+CM group, 4.21%±7.73% in the SW group, 10.45%±4.81% in the LW+CM group, 11.77%±3.83% in the LW group). The above differences were not statistically significant (P>0.05). Conclusions: The combination of a small bony access window and the use of a collagen membrane over the window favored new bone formation compared to other groups, but this result should be further investigated due to the limitations of the present animal model.

• Journal of Chest Surgery
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• 제24권3호
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• pp.280-286
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• 1991

Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta which originates just distal to the level of the origins of the coronary arteries It may be localized or diffuse. Enlargement of the aorta with a diamond-shaped patch of the noncoronary sinus of Valsalva was reported in 1961 by McGoon and associates But this reconstruction is asymmetric and the aortic obstruction may remain. In 1977, Dotty and associates reported the extended aortoplasty, the supravalvular ring was incised at two points in the noncoronary and in the right coronary sinuses of Valsalva closed with a tubular Dacron prosthesis of inverted Y-shape tailored to reconstruct the aorta We experienced three cases of the supravalvular aortic stenosis. The 11-year-old female and 4-year-old male with localized supravalvular aortic stenosis in William`s syndrome were operated with an inverted Y-shaped aortotomy toward the non-coronary sinus and the right coronary sinus and closed with "Hemashield`s collagen impregnated Dacron" tube graft, fashioned into "pantaloon" form patch. The 12-year-old male with localized supravalvular aortic stenosis and mitral insufficiency in William`s syndrome were operated with same procedure as two other patient above-mentioned for relief of supravalvular aortic stenosis and with mitral valve replacement. Postoperative course has been good.ourse has been good.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.345-351
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• 2012

Background Cranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction. Methods Between April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability. Results The mean follow-up period was 11.8 months and the mean operation time for reconstruction was $8.4{\pm}3.36$ hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures. Conclusions The reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

• Journal of Chest Surgery
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• 제18권3호
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• pp.456-460
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• 1985

A case of Annuloaortic Ectasia associated with Marfan syndrome was treated by replacement of aorta and aortic valve with a valved conduit. A 26 years old man had suffered from palpitation and precordial pain. He had stigmata of Marfan`s syndrome. Aortogram and 2-D echocardiogram confirmed aneurysm of the ascending aorta with aortic insufficiency. Surgery was performed under the moderate hypothermia to 28oC. There was marked dilatation of the aortic annulus as well as sinus of Valsalva, with displacement of the coronary ostia. Aortic valve and aneurysm was replacement with 25mm, woven Dacron tubular graft, to which a 25mm, S.T. Jude Medical valve had been previously sutured. Right & left coronary ostia were anastomosed to the graft with the use of 3O Nylon pledget suture. The patient had a satisfactory post operation period with out specific complication.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권4호
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• pp.428-434
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• 2008

Introduction: Piezosurgery device is one of the most commonly used instrument on the intraoral surgery such as maxillary sinus lift and autogeneous bone graft. Piezosurgery instrument also contains the tips that are manufactured especially for the convenient bone graft, which now many surgeons apply them for collecting bone graft materials in the curettage method for the restoration of skull defects. However, objective data has not been shown concerning the effects about bone graft with using Piezosurgery. Therefore we investigated the effects of Piezosurgery on the rabbit-skull defect healing. Materials & Methods: To investigate the regeneration of the bony defect with various bone graft, 10 adult New Zealand white rabbits (average weight : $2.8{\pm}0.3kg$, about 12weeks) were used. The four circular bony defects measuring 6mm in diameter were made with Piezosurgery device on each rabbit cranial bone. The harvested bone tissues during defect formation were also used for autogeneous bone graft. They were grafted into the defects in a various type; block type (Group 1), particulated type by the bone mill (Group 2), chopped type by curette shaped Piezosurgery tip (Group 3), the defect without any graft was served as control (control group). The animals were sacrificed after 6 weeks and bone regeneration capacity was evaluated histomorphometrically. Result & Conclusion: Autogeneous bone graft harvested using a Piezosurgery instrument showed satisfactory bone regeneration. There was no conspicuous difference bone prepared among by bone mill or Piezosurgery and block bone graft. Therefore, the bone harvested from the intraoral site near the operation field using the piezosurgery device can be a feasible and reliable graft for intraoral bony defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권5호
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• pp.452-457
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• 2001

Platelet-rich plasma is an autologous source of platelet-derived growth factor and transforming growth factor beta that is obtained by sequestering and concentrating platelets by gradient density centrifugation. We have used platelet-rich plasma for bone graft, especially allobone graft, at implant surgery, sinus lift procedure, and cyst enucleation. This article is retrospective study from October 1999 to November 2000. All cases were good healing and clinical success.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권4호
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• pp.306-313
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• 2009

Objectives: The aim of the present review was to evaluate survival rate and various factors associated with survival of osseointegrated implants. Patients and methods: The clinical comparisons were performed to evaluate survival rate of 794 endosseous implants that had been inserted between 2004 through 2008 in relation to sex and age of patients, position of implant, implant system and surface characteristics, length and diameter of implant, and bone graft technique. Results: The survival rate of implant was 94.3% in posterior area of maxilla and 98.6% in posterior area of mandible by position of implant, a statistically significant difference. As to diameter of implant, survival rate was 98.4% between the 4.0 and 4.5 mm and 75.0% in larger than 5.0 mm, that was statistically significant difference. There was a statistically significant difference regard to bone graft and surgical technique. The implant survival rate was 89.0% in a placement site which performed sinus lifting, and in case of implant placement with guided bone regeneration technique and without bone grafting was 97.6% and 100% each. Conclusion: According to these findings, this study establishes a relationship between survival rate of implant and position, surface characteristics, diameter of implant and bone graft technique.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.86-91
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• 2009

The success of implants essentially depends on a sufficient volume of healthy bone at the recipient site during implant placement. In patients who have the severe alveolar bone resorption or pneumatized maxillary sinus, it should be performed that bone regeneration procedure before implant placement. Development of barrier membrane makes it possible that predictable result of alveolar bone reconstruction. Many kind of materials used for barrier membrane technique are introduced, non-absorbable or absorbable membranes. But, when operation site was ruptured with membrane exposure, bacterias can be grow up at the bone graft site. Then morphology and migration of fibroblast will be changed. It works as a negative factor on healing process of bone graft site. In oral and maxillofacial department of Chonbuk national university dental hospital, we use variable suture technique like as subgingival suture, vertical mattress suture, simple interrupted suture, if need, tenting suture after GBR or block bone graft. Within these suture technique, wound healing was excellent without complication, so now we take a report of suture technique in reconstruction of alveolar bone surgery.

• Imaging Science in Dentistry
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• 제47권1호
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• pp.39-44
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• 2017

Purpose: Insufficient knowledge of the anatomy of the maxillary sinuses prior to sinus graft surgery may lead to perioperative or postoperative complications. This study sought to characterize the position of the posterior superior alveolar artery (PSAA) within the maxillary sinuses using cone-beam computed tomography (CBCT). Materials and Methods: A total of 300 patients with edentulous posterior maxillae, including 138 females and 162 males with an age range of 33-86 years, who presented to a radiology clinic between 2013 and 2015 were enrolled in this retrospective cross-sectional study. The distance from the inferior border of the PSAA to the alveolar crest according to the residual ridge classification by Lekholm and Zarb, the distance from the PSAA to the nasal septum and zygomatic arch, and the diameter and position of the PSAA were all assessed on patients' CBCT scans. The data were analyzed using the Mann-Whitney test and the t-test. Results: The PSAA was detected on the CBCT scans of 87% of the patients; it was located beneath the sinus membrane in 47% of cases and was intraosseous in 47% of cases. The diameter of the artery was between 1 and 2 mm in most patients (72%). The mean diameter of the artery was $1.29{\pm}0.39mm$, and the mean distances from the PSAA to the zygomatic arch, nasal septum, and alveolar crest were $22.59{\pm}4.89mm$, $26.51{\pm}3.52mm$, and $16.7{\pm}3.96mm$, respectively. Conclusion: The likelihood of detecting the PSAA on CBCT scans is high; its location is intraosseous or beneath the sinus membrane in most patients. Determining the exact location of the PSAA on CBCT scans preoperatively can help prevent it from being damaged during surgery.

• Journal of Periodontal and Implant Science
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• 제38권4호
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• pp.669-678
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• 2008

Purpose: The purpose of this study was to evaluate 2 years cumulative survival rate of implants on augmented sinus area using MBCP, mixture of MBCP and ICB, and mixture of MBCP and autogenous bone by means of clinical and radiologic methods. Materials and Methods: In a total of 37 patients, 41 maxillary sinuses were augmented and 89 implant fixtures were installed simultaneously or after a regular healing period. The patients were divided in 3 groups: MBCP only, MBCP combined with ICB, MBCP combined with autogenous bone. After delivery of prosthesis, along 2 years of observation period, all implants were evaluated clinically and radiologically. And the results were as follows. Results: The results of this study were as follows. 1. A 2 year cumulative survival rate of implants placed with sinus augmentation procedure using MBCP was 97.75%. 2. Survival rate of implants using MBCP only was 97.62%, MBCP and ICB was 100%, MBCP and autogenous bone was 95%. There was no statistically significant difference between 3 groups. 3. Only 2 of 89 implants were lost before delivery of prosthesis, so it can be regarded as an early failure. And both were successfully restored by wider implants. Conclusion: It can be suggested that MBCP may have predictable result when used as a grafting material of sinus floor augmentation whether combined with other graft(ICB, autogenous bone) or not. And the diameter, length, location of implants did not have a significant effect on 2 year cumulative survival rate.