• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권4호
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• pp.449-453
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• 2000

저자등은 하악 복잡골절 정복후 골과 연조직 결손을 보이는 환자에게 internal resorvoir를 이용한 연조직 확장 후 장골 이식으로 골결손 수복을 함으로써 양호한 안모개선을 얻었기에 문헌고찰과 함께 보고하는 바이다.

• 대한두개안면성형외과학회지
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• 제22권3호
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• pp.161-163
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• 2021

The soft tissue triangle is an easily recognizable subunit of the nose. Therefore, deformities in this region resulting from trauma or complications after cosmetic surgery can have serious cosmetic impacts. Various reconstruction choices exist for deformities such as depression of the soft triangle but choosing the most appropriate treatment in each case remains a challenge. In the case described herein, a patient underwent augmentation rhinoplasty with a silastic implant and experienced implant exposure in the soft triangle area. After implant removal, the patient complained of depression in this area. The authors effectively solved this problem through a de-epithelialized composite tissue graft. In this report, we present this case and review similar cases of reconstruction of the soft triangle.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.111-116
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• 2006

An infection after total knee arthroplasty has many complications such as severe bone defect, skin and soft tissue problems, devastated general condition, so arthrodesis is preferred as treatment option. However, poor bony contact due to severe bone defect and inadequate conditions of the soft tissue often cause nonunion or severe limb shortening after arthrodesis. More over these conditions, it is not easy to choose appropriate fixative devices. In these situations, the arthrodesis using vascularized fibular graft can be the solution. Vascularized fibular graft (VFG) can playa role as a suitable material for the treatment of bone defects. And VFG can overcome poor blood circulation caused by scar tissues, and can be relatively more durable and adequate length. In the long term, VFG can be hypertrophied by weight bearing, and will give mechanical stablility. The purpose of the paper is to report the successful results of arthrodesis using VFG in a patient who got extensive bone defect after failed revision total knee arthroplasty with infection.

• Journal of Periodontal and Implant Science
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• 제38권2호
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• pp.207-214
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• 2008

Purpose: The aim of augmentation of the alveolar ridge is to restore absorbed alveolar ridges for future implant site or esthetic prosthodontic restoration. The present clinical report describes the anterior maxillary augmentation cases using a soft tissue rotated palatal flap, and considers various problems of before and after surgery. Method: First & second patients were treated by vascularized interpositional periosteal-connective tissue(VIP-CT) flap for horizontal soft tissue augmentation. Especially second patient was progressed with bone grafting at the same time. Third patient was treated by the same flap with bone graft and implant placement in single tooth missing premaxillary area. Result: The obtained horizontal augmentation width measured $0.5{\sim}2.7\;mm$. Conclusion: This technique constitutes a viable approach for augmentation the anterior sector of alveolar ridge with the placement of dental implants. But it needs correct diagnosis preparation and careful surgery skill.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.29.1-29.7
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• 2015

Facial asymmetry is found in patients with or without cosmetic facial alterations. Some patients have facial asymmetry that manifests underlying skeletal problems, while others have only limited soft-tissue facial asymmetry. Orthognathic surgery brings about a dermatic change, as soft tissue covers underlying bones. Limited soft-tissue asymmetry, meanwhile, is difficult to correct. The treatment modalities for the creation or restoration of an esthetically pleasing appearance were autogenous fat grafts, cartilage graft, and silicon injections. A young female patient had right-side facial asymmetry. The clinical assessment involved visual inspection of the face and palpation to differentiate soft tissue and bone. Although the extra-oral examination found facial asymmetry with skin atrophy, the radiographic findings revealed no mandibular atrophy or deviation. She was diagnosed as localized scleroderma with muscle spasm. In conclusion, facial asymmetry patients with skeletal asymmetry can be esthetically satisfied by orthognathic surgery; however, facial atrophy patients with skin or subdermal tissue contraction need treatment by cosmetic dermatological surgery and orthodontic correction.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.526-530
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• 2010

Purpose: With the recent recognition of the importance of soft-tissue fillers, fat grafting has been assumed an increasingly important role as both an adjunctive and a primary procedure in aesthetic and reconstructive surgery. The main problem in achieving long-term soft-tissue augmentation is partial absorption of the injected fat and hence the need for overcorrection and re-injection. The purpose of this study is to improve the viability of the injected fat by the use of Lipo-PGE1. Methods: Human adipose tissue, obtained by suctionassisted lipectomy, was re -injected into the subcutaneous layer in the scalp of ICR mice. Lipo-PGE1 ($0.5{\mu}g$/kg) was injected intravenously in experimental group for 7 days from the operation day and saline was injected in control group. There were 5 animals in each group. The animals were euthanized 4 weeks after the procedure. Graft weight and volume were measured and histologic evaluation was performed. Result: Histologic analysis demonstrated significantly less cyst formation and less inflammatory reaction in the group treated with Lipo-PGE1. No significant difference was found between the groups regarding graft volume or the other histologic parameters investigated. Significant differences were demonstrated in microvascular density count. Conclusion: Less cyst formation, less inflammation, more angiogenesis indicating improved quality of the injected fat can be obtained by the addition of Lipo-PGE1. Further studies of various dosages of Lipo-PGE1 and their long-term effect are required before these encouraging results could be applied clinically.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권5호
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• pp.192-200
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• 2014

Purpose: The objective of this study was to evaluate the interaction between 4-hexylresorcinol (4HR) and antibody as that affects the performance of a silk-4HR combination graft for soft tissue augmentation in an animal model. Methods: The silk graft materials consisted of four types: silk+10% tricalcium phosphate (TCP) (ST0), silk+10% TCP+1% 4HR (ST1), silk+10% TCP+3% 4HR (ST3), and silk+10% TCP+6% 4-HR (ST6). The antibody binding assay tested the 4HR effect and scanning electron microscopic (SEM) exam was done for silk grafts. The animal experiment used a subcutaneous pocket mouse model. The graft - SH0 or SH1 or SH3 or SH6 - was placed in a subcutaneous pocket. The animals were killed at one, two, and four weeks, postoperatively. The specimens were subjected to histological analysis and lysozyme assay. Results: Groups with 4HR applied showed lower antibody binding affinity to antigen compared to groups without 4HR. In the SEM examination, there was no significant difference among groups. Histological examinations revealed many foreign body giant cells in ST0 and ST1 group at four weeks postoperatively. Both ST3 and ST6 groups developed significantly lower levels of giant cell values compared to ST0 and ST1 groups (P < 0.001) at four weeks postoperatively. In the lysozyme assay, the ST1 and ST3 groups showed denser signals than the other groups. Conclusion: 4HR combined silk implants resulted in high levels of vascular and connective tissue regeneration.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.27-36
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• 2000

February 1995 to September 1999, authors have experienced seven cases of infected nonunion of tibial fractures with associated soft tissue injury and skin defect, and have accomplished union in all cases by free vascularized fibular graft. All grafts healed with no radiographic evidence of bone necrosis or resorption and have been able to treat large bony defect and skin defect simultaneously. In this study, five cases of vascularized free fibular osteocutaneous flap transfer and two cases of free fibular graft are reported. All of seven cases were infected nonunion of tibia. The results were obtained as follows 1) The mean duration of the radiologic bone union was average 5.3months. 2) Grafted fibular has been hypertrophied, average 10.6 months. 3) In five cases of preservation of posterior cortex of tibia, bony union and hypertrophy of grafted bone were earlier than that two cases of complete segmental resection of tibia. 4) In two cases which only free vascularized fibular graft were performed because achievement of cutaneous flap was failed, authors found that soft tissue defect was filled with granulation tissue and split-thickness skin graft was possible over the granulation tissue after 3 weeks postoperatively.

• 대한심미치과학회지
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• 제30권2호
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• pp.102-111
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• 2021

전치부 영역에서 임플란트는 경, 연조직 조화가 필요하며 다양한 단계를 필요로 한다. 이 중 순측의 함몰은 연조직 이식을 통해 좋은 결과를 얻을 수 있다. 치은퇴축을 위한 피개가 아닌 함몰을 위한 연조직 이식은 공여부의 선택에 있어서 구개측에 비해 상악결절부위에서의 채득으로 연조직의 볼륨을 보다 증가시킬 수 있으며 출혈이나 술후 통증을 줄이고, 공여부의 치유를 빠르게 하는 장점이 있어 좋은 치료 선택이 될 수 있을 것이다.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.172-181
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• 2023

Purpose: To investigate the effect of epidermal growth factor (EGF) with collagen matrix (CM) for increasing gingival thickness. Materials and Methods: In five mongrel dogs, bilateral gingival defects were surgically made on the maxillary canines. After two months, either a subepithelial connective tissue graft (group SCTG) or CM with EGF (0.1 ug/ml, group EGF) was grafted, and the flap was coronally positioned to cover the graft materials. The animals were sacrificed after three months. Intraoral scanning was performed for soft tissue analysis. Histologic and histomorphometric analyses were performed. Result: Two animals exhibited wound dehiscence during the healing phase, leaving three for analysis. No statistically significant difference was found in soft tissue changes (P>0.05). The level of gingival margin (GM) increased in both groups (1.02±0.74 mm in group SCTG vs. 1.24±0.83 mm in group EGF). Linear increases at the GM pre-augmentation in the soft tissue profile were 1.08±0.58 mm in group SCTG and 0.96±0.73 mm in group EGF. Histomorphometric parameters (keratinized tissue height, tissue thickness, and rete peg density) were not significantly different between the groups (P>0.05). Conclusion: EGF loaded onto CM led to comparable gingival phenotype enhancement to SCTG.