• Title/Summary/Keyword: Soft-tissue procedure

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ELECTROSURGERY IN DENTAL PRACTICE-A CASE REPORT (Electrosurgery를 이용한 치료증례)

  • Yoon, Jae-Woong;Lee, Sang-Hoon;Lee, Kwang-Soo;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.3
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    • pp.631-639
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    • 1996
  • Electrosurgical technique have been used in dentistry as an aid to soft tissue management for nearly 60 years. However, it was not until the late 1960s that the principles of electrosurgery were understood and improved equipment became available. Electrosurgery is a surgical procedure performed on soft tissue utilizing controlled high frequency electricaI(radio-frequency) currents in the range of 1,500,000 to 7,500,000 cyclesper second. The radio-frequency energy used in electrosurgery is able to cut and coagulate tissue because it focuses the energy at the small, active electrode. Advantages of electrosurgery for soft-tissue management during dental procedures include improved hemostasis, ease of tissue modification, improved visibility and so on, but adverse healing responses-including necrosis of soft tissue and sequestration of alveolar bone-have been reported. The present report provides examples of treatment of soft tissue and pulp tissue of primary teeth by electrosurgery. The results are as follows; 1. Electrosurgical techniques can be used for various procedures in pedodontics. 2. Electrosurgical procedures provide improved hemostasis and visibility in the operating field, which enable to remove, reshape, and contour soft tissues easily. 3. In pulpotomy technique, it was difficult to expect the variable pulpal response based on the degree of heat accumulation and the conditions of pulp tissues. Therefore, electrosurgical pulpotomy could not be considered as a method superior to formocresol pulpotomy. 4. A greater degree of dexterity and experiences in manipulation of the electrode is required compared with the conventional scalpel surgery.

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Management of Failed Thumb Replantation (Early Soft Tissue Removal with Vascularized Flap Coverage of Amputated Phalangeal Bone) (무지 재접합 실패예에 대한 조기 치료로서 절단부의 수지골과 유리 피판술을 이용한 무지의 재건)

  • Chung, Duke-Whan;Kim, Ki-Bong
    • Archives of Reconstructive Microsurgery
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    • v.10 no.2
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    • pp.86-92
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    • 2001
  • Failure of replantation is inevitable in finger replantation surgery, around 10% of failure rate are reported in many authors. Management of the failed finger replantation is one of big dilemma to microsurgeons. We report 5 cases of thumb reconstruction after failure of replantation. The reconstructive surgery composed with early debridement of soft tissue that are under gangrenous processing, extract the phalangeal bone without any soft tissues. Osteosynthesis of the extracted phalangeal bone with host phalangeal bone. The exposed bony portion covered with vascularized flaps such as revered radial forearm pedicled flap, free radial forearm flap and neurovascular island finger flap. This procedure underwent within a week after vascular insufficiency developed. All of the flaps are survived, bone union achieved within 3 months. The function and external appearance of the reconstructed thumb were encouraging; Pinch Power was average 1.2 Pounds. Early removal of necrotizing soft tissue followed by covering none vascular phalangeal bone which extracted from the dead phalanx with vascularized flap is one of the useful alterative solutions in failed replantation surgery in hand.

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CAD/CAM splint based on soft tissue 3D simulation for treatment of facial asymmetry

  • Tominaga, Kazuhiro;Habu, Manabu;Tsurushima, Hiroki;Takahashi, Osamu;Yoshioka, Izumi
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.4.1-4.6
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    • 2016
  • Background: Most cases of facial asymmetry involve yaw deformity, and determination of the yaw correction level is very difficult. Methods: We use three-dimensional soft tissue simulation to determine the yaw correction level. This three-dimensional simulation is based on the addition of cephalometric prediction to gradual yaw correction. Optimal yaw correction is determined visually, and an intermediate splint is fabricated with computer-aided design and computer-aided manufacturing. Application of positioning devices and the performance of horseshoe osteotomy are advisable. Results: With this procedure, accurate repositioning of jaws was confirmed and patients obtained fairly good facial contour. Conclusions: This procedure is a promising method for a widespread, predictable treatment of facial asymmetry.

Long-Term Outcome of Free Rectus Abdominis Musculocutaneous Flap for General Soft-Tissue Reconstruction

  • Park, Jungheum;Son, Daegu;Song, Joongwon
    • Archives of Reconstructive Microsurgery
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    • v.24 no.1
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    • pp.7-12
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    • 2015
  • Purpose: The rectus abdominis musculocutaneous (RAM) flap has contributed to the efficient reconstruction of soft tissue defects. The flap has the advantage of easy dissection, minimal donor site morbidity, and the constant vascular anatomy with long pedicle. Authors used the free RAM flap to reconstruct multi-located soft tissue defects while still considering functionality and aesthetics. We present the long-term outcomes and versatility of free RAM flaps. Materials and Methods: From 1994 to 2004, all patients who underwent soft tissue reconstruction with free RAM flap were reviewed retrospectively. The site of the reconstruction, vessels of anastomosis, type of RAM flap, and outcomes, including flap success rate, hospital stay after flap transfer, conduction of secondary procedure, flap complications, and donor-site complications were analyzed. Results: Twenty-one patients underwent 24 free RAM flaps in site of breast, face, upper extremity and lower extremity. Mean follow-up period was 36.1 months (range, 3~156 months). The overall success rate was 92% with only a loss of 2 flaps. Minor complications related to transferred flaps were necrosis of 2 partial flaps, hematoma formation in 3 cases, and a wound infection in 1 case. Donor site morbidity was not observed. Debulking surgery was performed in 4 patients, and scar revision was performed in 3 patients. Conclusion: Free RAM flap is a workhorse flap for general soft-tissue reconstruction with minimal donor site morbidity with aesthetically good results. Thus, the free RAM flaps are versatile, and sturdy for any sites of soft-tissue where reconstruction could be performed.

Correction of Lip Canting Using Bioabsorbables during Orthognathic Surgery

  • Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.4
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    • pp.178-183
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    • 2014
  • Lip canting is associated with facial asymmetry, and is one of the most challenging problems in surgical correction of facial deformities. The author corrected lip canting using bioabsorbable devices during orthognathic surgery. Soft tissue suspension procedures were performed on four patients with facial asymmetry. Lip lines improved for all patients. Over an observation period of five years, no complications were noted, nor did any late relapse develop. Furthermore, as time past, the effect of the Endotine suspension procedure increased probably due to induction of fibrosis on surrounding soft tissues.

Soft Tissue Balancing on Total Ankle Replacement Surgery (발목 관절 전치환술에서의 연부조직 재정렬술)

  • Sungwook Choi;Dae Whan Kim;Hyunseong Kang
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.1
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    • pp.1-7
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    • 2024
  • Despite the advances in total ankle replacement (TAR), TAR has emerged as a promising alternative to ankle arthrodesis, particularly in severe ankle arthritis. Restoring ankle stability and alignment is the most important technical consideration and the goal of TAR. Hence, additional procedures, such as soft tissue balancing and osteotomies, are often critical parts of surgical planning. This article reviews the basics of joint balancing, offering suggestions on procedure selection for ligamentous balancing and varus and valgus malalignment in TARs.

Ankle Lesions, Associated with Anterior Soft Tissue Impingement (전방 연부조직 충돌과 동반된 족관절 병변)

  • Sung, Il-Hoon;Kim, Suk-Hwan;Shim, Kyu-Dong;Lee, Jun-Hwan;Kang, Chang-Nam
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.115-118
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    • 2010
  • Purpose: To evaluate clinical features of ankle lesions, associated with anterior soft tissue impingement. Materials and Methods: We retrospectively reviewed 21 patients who had chronic anterior ankle pain as initial symptom and associated ankle lesions with anterior soft tissue impingement. Based on preoperative radiologic findings, physical examination intra-operative findings, appropriate procedures were done for lesions by either arthroscopic or minimal open procedure or combined. Clinical evaluation was done using American Orthopedic Foot and Ankle Society, ankle-hind foot score (AOFAS score) and visual analog scale (VAS) on last follow up. Results: Associated lesion(s) to anterior soft tissue impingement of the ankle were 16 cases of osteochondral lesion of talus, 14 cases of bony impingement, 6 cases of ankle lateral instability, 5 cases of loose body, 4 cases of os subfibulare. AOFAS score was $58.9\;{\pm}\;5.1$ preoperatively and $74\;{\pm}\;9.1$ on last follow up. Clinical satisfaction score using VAS showed excellent in 3 cases, good in 11, fair in 3, poor in 4. Conclusion: The patients who had anterior soft tissue impingement would have various associated lesions on their ankle. In such cases, preoperative counseling for variety of postoperative results would be needed.

Gingival recontouring by provisional implant restoration for optimal emergence profile: report of two cases

  • Son, Mee-Kyoung;Jang, Hyun-Seon
    • Journal of Periodontal and Implant Science
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    • v.41 no.6
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    • pp.302-308
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    • 2011
  • Purpose: The emergence profile concept of an implant restoration is one of the most important factors for the esthetics and health of peri-implant soft tissue. This paper reports on two cases of gingival recontouring by the fabrication of a provisional implant restoration to produce an optimal emergence profile of a definitive implant restoration. Methods: After the second surgery, a preliminary impression was taken to make a soft tissue working cast. A provisional crown was fabricated on the model. The soft tissue around the implant fixture on the model was trimmed with a laboratory scalpel to produce the scalloped gingival form. Light curing composite resin was added to fill the space between the provisional crown base and trimmed gingiva. After 4 to 6 weeks, the final impression was taken to make a definitive implant restoration, where the soft tissue and tooth form were in harmony with the adjacent tooth. Results: At the first insertion of the provisional restoration, gum bleaching revealed gingival pressure. Four to six weeks after placing the provisional restoration, the gum reformed with harmony between the peri-implant gingiva and adjacent dentition. Conclusions: Gingival recontouring with a provisional implant restoration is a non-surgical and non-procedure-sensitive method. The implant restoration with the optimal emergence profile is expected to provide superior esthetic and functional results.

Reconstruction of Soft Tissue Defect of Lower Extremity with Anterolateral Thigh Perforator Flap (전외측 대퇴부 천공지 피판을 이용한 하지 연부조직 결손의 재건)

  • Kim, Kyung-Chul;Chung, Chae-Ik;Kim, Seong-Eoun;Kim, Hak-Soo;Rhyou, In-Hyeok
    • Archives of Reconstructive Microsurgery
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    • v.15 no.2
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    • pp.70-76
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    • 2006
  • This study investigated the clinical application of anterolateral thigh (ALT) perforator flap in reconstruction of soft tissue defect of lower extremity. There were twenty-one patients who had been taken soft tissue reconstruction with anterolateral thigh perforator flap. There were 19 males and 2 females between 3 and 65 years (mean, 36 years). This study included 4 cases of pedatric case of under 10-year-old. All cases were a cutaneous flap. Flap size averaged $160\;cm^2\;(20{\sim}450\;cm^2)$. 19 cases were musculocutaneous perforator flaps and 2 were septocutaneous perforator. T-shaped pedicle were used to reconstruct and to preserve major artery of lower extremity in 2 cases. 19 cases flaps survived completely and 2 cases flap were marginal necrosis partially. There was venous congestion in one case of type of reverse island flap but that was improved after salvage procedure with leech. While the donor sites were closed directly in 5cases, 16 cases underwent skin graft. ALT flap is suitable for coverage of defects in lower extremity where have various condition and reliable in children as in adult.

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Lower Extremity Reconstruction of Soft Tissue Defects with Perforator Island Flap (하지의 연부조직 결손에 있어 천공지 도서형 피판술을 이용한 재건)

  • Lee, Tae Hoon;Choi, Jae Won;Lee, Jun Ho;Kim, Hyo Heon
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.435-440
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    • 2005
  • The reconstruction of deep soft tissue defects of lower extremities combined with bone exposure has been difficult problems. When it is impossible to raise local skin flap, we have been usually used the gastrocnemius musculocutaneous flap, cross leg flap or free flaps. However, In musculocutaneous flap, aesthetical appearance of the calf is not appropriate because of too bulky flap. Although the success rate of the free flap has improved, still failure of flap occurs in cases of the chronic ischemic state. As the concepts of perforator flap has recently developed and widely used due to its thin flap thickness. Between January 2002 to December 2004, we treated 7 patients with soft tissue defect in leg with chronic ischemic limbs with perforator island flap. Preoperative angiography were done in all case and we used 2 medial sural perforator flaps, 1 anterior tibial artery perforator flap, 1 posterior tibial artery perforator flap, 3 anterolateral thigh perforator flap. Partial necrosis of flap was seen in one patient but no further surgical procedure was required for wound healed spontaneously. Perforator island flaps are thin, reduce donor site morbidity, conceal donor site with primary closure and it is useful for resurfacing soft tissue defect of lower extremities.