• Title/Summary/Keyword: Tissue graft

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Reconstruction of Interdental papilla through ELSA technique : A Clinical Case Report (ELSA테크닉을 이용한 치간유두의 재생)

  • Jung, Sung Koog
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.30 no.2
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    • pp.91-101
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    • 2021
  • The interdental papilla area is a difficult area for connective tissue graft (CTG) due to its narrow space. So Regeneration of interdental papilla is very challenging work. It is very difficult when the teeth have contact with adjacent teeth, but if there was only 3mm of space between the teeth, CTG was not very difficult. Therefore, through the orthodontic force, a 3mm space between the teeth was intentionally created. The CTG was performed using a microblade, and only one vertical incision was performed off the gingival margin, and the graft was performed by inserting the grafts through here. After a period of maintenance, I was able to gather the teeth again with orthodontic force and regenerate the interdental papilla. I named this technique ELSA Technique (Enlargement of space - Labial graft - Squeezing - for Augmentation of papilla). If interdental papilla is lost due to periodontal disease, ELSA techniques can regenerate interdental papilla very efficiently.

Left lobe living donor liver transplantation using the resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (RAPID) procedure in cirrhotic patients: First case report in Korea

  • Jongman Kim;Jinsoo Rhu;Eunjin Lee;Youngju Ryu;Sunghyo An;Sung Jun Jo;Namkee Oh;Seungwook Han;Sunghae Park;Gyu-Seong Choi
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.3
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    • pp.388-392
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    • 2024
  • In liver transplantation, the primary concern is to ensure an adequate future liver remnant (FLR) volume for the donor, while selecting a graft of sufficient size for the recipient. The living donor-resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (LD-RAPID) procedure offers a potential solution to expand the donor pool for living donor liver transplantation (LDLT). We report the first case involving a cirrhotic patient with autoimmune hepatitis and hepatocellular carcinoma, who underwent left lobe LDLT using the LD-RAPID procedure. The living liver donor (LLD) underwent a laparoscopic left hepatectomy, including middle hepatic vein. The resection on the recipient side was an extended left hepatectomy, including the middle hepatic vein orifice and caudate lobe. At postoperative day 7, a computed tomography scan showed hypertrophy of the left graft from 320 g to 465 mL (i.e., a 45.3% increase in graft volume body weight ratio from 0.60% to 0.77%). After a 7-day interval, the diseased right lobe was removed in the second stage surgery. The LD-RAPID procedure using left lobe graft allows for the use of a small liver graft or small FLR volume in LLD in LDLT, which expands the donor pool to minimize the risk to LLD by enabling the donation of a smaller liver portion.

구강내 공여부에서 채취한 자가골 이식을 동반한 조직 유도 재생술의 임상적 치험례

  • Kim, Tae-Hun;Lee, Sung-Hee
    • The Journal of the Korean dental association
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    • v.37 no.2 s.357
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    • pp.137-145
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    • 1999
  • More and more, esthetic and functional reconstruction of intra oral bone defect by trauma, pathologic disease is increasing in these days. the study about this field is going. Autogenous bone graft has advantage in biocompatyibility, but loss of donor material was relatively large. Allogenic graft has disadvantage in immunologic refusal reaction. We reconstructed several cases of periodontal, alveolar bone defects and pathologic bone defects, In all cases, we used resorbable membrane Biomesh and autogenous bone graft from retromolar triangle area, chin, torus, maxillary tuberosity, and extraction socket. From these cases, we obtained good prognosis, so we report clinical cases of Guided Tissue Regeneration with autogenous bone graft.

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DENTAL IMPLANT TREATMENT WITH ILIAC BONE GRAFT VIA TWO-STAGE APPROACH FOR AVULSED ALVEOLAR BONE DEFECTS; CASE REPORT (외상성 치조골 상실 후 장골 이식을 동반한 이회법 임플란트 치료; 증례보고)

  • Choi, Young-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.4
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    • pp.386-390
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    • 2007
  • This is about the case of loss of multiple teeth and alveolar bone caused by trauma, which needed alveolar bone augmentation before implant treatment. Alveolar bone was reconstructed using iliac bone graft, and thereafter first implant surgery was followed by consolidation period of 3 months. Iliac bone resorption was observed at the time of implant placement. And that resorption was more in the horizontal dimension than in the vertical. We conclude that additional treatment planning(e.g. using alveolar distraction osteogenesis or tissue expander) should be considered besides bone graft for vertical alveolar bone augmentation. For both maxilla and mandible, prosthodontic treatment was carried out $4{\sim}5$ months after implant placement. To compensate alveolar bone deficiency, partial hybrid overdenture on maxilla and implant-supported fixed bridge on mandible were fabricated, and the total treatment was finished.

Clinical application and classification of bone graft material according to component (임상가를 위한 특집 2 - 구성성분별 골이식재의 분류와 임상적용)

  • Kim, Young-Kyun
    • The Journal of the Korean dental association
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    • v.48 no.4
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    • pp.263-274
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    • 2010
  • I classified the bone graft material according to the component. Most bone graft material is composed of inorganic and organic constituent. Organic component such DBM is associated with osteoinduction. Inorganic components such as hydroxyapatite, $\beta$-TCP, calcium sulfate, bioactive glass, polymer are associated with osteoconduction. Autogenous bone graft is ideal material. We can select any biocompatible material for the restoration of small filling defect with intact bony wall. However, we should select first osteogenetic and osteoinductive material to regenerate the viable bone tissue.

A study of the clinical effects of various bone graft materials (다양한 골 이식재의 임상 효과에 대한 고찰)

  • Lee, Seung-Bum;Yon, Je-Young;Chae, Gyung-Joon;Jung, Ui-Won;Kim, Chang-Sung;Lee, Yong-Geun;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.37 no.4
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    • pp.719-732
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    • 2007
  • Purpose: Various bone graft materials are being used for periodontal tissue regeneration. Th materials are being developed continuously for ideal clinical effects. Therefore, it is necessary to identify the clinical characteristics of each bone graft material through comparing the various bone graft materials statistically and in doing so, proposing a more efficient bone graft material. In this study, the following results were attained through comparing the clinical effects among the bone graft materials, using the statistical method based on the clinical studies published at the department of periodontology of Yonsei hospital. Materials and Method: 6 selected studies of department of Periodontology at Yonsei University Hospital were based on clinical study of bone grafting in intrabony defects. It was compared the clinical parameters among the 6 clinical studies, using the statistical META analysis. Result: When comparing the probing depth reduction, there was a relatively great amount of decease when using the xenograft, Anorganic Bovine Derived Hydroxapatite Bone Matrix/Cell Binding Peptide(ABM/P-15: PepGen $P-15^{(R)}$) and the autogenous bone and absorbable membrane, d, 1-alctide/glycolide copolymer(GC: $Biomesh^{(R)}$). The allogfrafts showed a relatively low decrease in the probing depth and clinical attachment change. It also showed a slight decrease in the bone probing depth. The allografts showed various results according to different bone graft materials. When comparing the ABM/P-15 and bovine bone $powder(BBP^{(R)})$, ABM/P-15 showed a relatively high clinical attachment level and the bovine bone powder showed a relatively high clinical attachment level. The probing depth change and gingival recession change showed a lower value than the mean value between the two bone graft materials. The synthetic bone showed a relatively high decrease in clinical attachment level and periodontal probing depth change. There was a relatively larger amount of gingival recession when using Bioactive Glass(BG) but a relatively low bone regeneration effect was seen. Conclusion: Good restorative results of the periodontal tissue can be attained by applying the various bone graft materials being used today after identifying the accurate clinical effects.

In vitro investigation of algin impregnated vascular graft (알진이 도포된 인공혈관의 물성 평가)

  • Lee, Jin-Ho;Shin, Bung-Chul;Khang, Gil-Son;Lee, Hai-Bang
    • Proceedings of the KOSOMBE Conference
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    • v.1990 no.05
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    • pp.9-12
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    • 1990
  • He impregnated a highly porous, knitted polyester (Dacron) graft with a biodegradable nonproteinaceous material, algin. This new vascular graft is blood tight but still retains high porosity in the body. It does not need to be preclotted with blood before implantation and has good tissue ingrowth and biological healing properties due to the high porosity. The algin impregnated graft was investigated by "in vitro" examinations in this study. It was characterized by ESCA analysis, SEM observation, and measurements of water permeability, algin coating weight, mechanical properties and whole blood clotting time. The water permeability of the graft was reduced more than 99% by the algin impregnation treatment without changing any mechanical properties. "In vivo" examinations of the algin impregnated vascular graft are on progress.

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Flow Visualization in Realistic Arterial Bypass Graft Model

  • Singh, Megha;Shin, Se-Hyun
    • International Journal of Vascular Biomedical Engineering
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    • v.3 no.1
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    • pp.1-5
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    • 2005
  • Background: Coronary atherosclerosis artery disease is the leading cause of morbidity and mortality. Coronary artery bypass grafting (CABG) which utilizes the saphenous vein graft, has helped in alleviating the suffering of these patients. Newer techniques are being developed to improve upon the techniques. Still there is significant number of failures, leading to re-grafting or re-vascularization. Some studies have helped in identifying the high and low shear stress regions. Further studies based on their realistic models are required. Material, methods and results: we developed the realistic model of fully blocked right coronary with bypass graft placed at angle of $5^0$ with curvature similar to that of artery. Pulsatile flow of birefringent solution through this model by polarized light was visualized. The images of complete flow field in the model were recorded and analyzed. Regions of high flow disturbances which are prone to further changes are identified. Existence of recirculation in the blocked coronary may initiate new blood-tissue interactions deleterious to bypass graft. Conclusion: Our study shows that by selecting the procedure to place bypass graft at minimum angle with curvature similar to that of artery and smooth sutures may improve the life span of the graft. This study also identified that coronary blocked regions contributing by recirculation flow at the proximal and distal regions of bypass which may require further studies.

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Reconstruction of Tibia Defect with Free Flap Followed by Ipsilateral Fibular Transposition (유리 피판술과 동측 비골 전위술을 이용한 경골 결손의 재건)

  • Chung, Duke-Whan;Park, Jun-Young;Han, Chung-Soo
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.42-49
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    • 2005
  • Between June 1989 and may 2004 Ipsilateral vascularized fibular transposition was performed on nine patients with segmental tibial defects combined with infection following trauma. Ipsilateral vascularized fibular graft was performed on two or three stage according to the degree of infection. Initially free vascular pedicled graft was done followed by ipsilateral vascularized fibular graft. Type of free flap used is scapular free flap 3 cases, latissimus dorsi free flap 5 cases and dorsalis pedis flap 1 cases. The patients were followed for an average of 3.4 years. the average time to union was 6.7 months, and in all patients the graft healed in spite of complication. Complication was free flap venous thrombosis in 1 cases, persistent infection in 1 cases, delayed bony union at the distal end of fibular graft in 2 cases. The results showed that more faster bony union was seen in which cases firmly internally fixated and more faster hypertrophy of graft in which cases was permitted to ambulate on early weight bearing and more faster healing in which cases debrided more meticulously. Reconstruction of tibia defect with free flap followed by Ipsilateral fibular transposition is a useful and safe method to avoid the potential risk of infection for patients with tibial large bone defect and soft tissue defect associated with infection.

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Treatment of Aplasia Cutis Congenita on Scalp using Hyalomatix$^{(R)}$: A Case Report (하이알로매트릭스를 이용한, 두개골결손을 동반한 선천성피부무형성증의 치료: 1례 보고)

  • Rhee, Suk-Hyun;Hong, Jong-Won;Roh, Tai-Suk;Kim, Young-Seok;Rah, Dong-Kyun
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.469-472
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    • 2010
  • Purpose: Aplasia Cutis Congenita (ACC) is a rare disease characterized by the focal defect of the skin at birth, frequently involving scalp, but it may affect any region of the body. There are no etiology known but some conditions such as intrauterine vascular ischemia, amniotic adherences and viral infections are associated. The ideal treatment for the ACC is not known. Superficial and relatively small sized defects (< $3{\times}5\;cm$) may heal spontaneously and large defects related with risks of infection and bleeding may require aggressive surgical treatment. Hyalomatrix$^{(R)}$ is a bilayer of an esterified hyaluronan scaffold beneath a silicone membrane. It has been used as a temporary dermal substitute to cover deep thickness skin defect and has physiological functions derive from the structural role in extracellular matrix and interaction with cell surface receptor. This material has been used for the wound bed pre-treatment for skin graft to follow and especially in uncooperative patient, like a newborn, this could be a efficient and aseptic way of promoting granulation without daily irritative wound care. For this reason, using Hyalomatrix$^{(R)}$ for the treatment of ACC was preferred in this paper. Methods: We report a case of a newborn with ACC of the vertex scalp and non-ossified partial skull defect. The large sized skin and skull defect ($6{\times}6\;cm$) was found with intact dura mater. No other complications such as bleeding or abnormal neurologic sign were accompanied. Escharectomy was performed and Hyalomatrix$^{(R)}$ was applied for the protection and the induction of acute wound healing for 3 months before the split-thickness skin graft. During the 3 months period, the dressing was renewed in aseptic technique for every 3 weeks. The skin graft was achieved on the healthy granulation bed. Results: The operative procedure was uneventful without necessity of blood transfusion. Postoperative physical examination revealed no additional abnormalities. Regular wound management was performed in out-patient clinic and the grafted skin was taken completely. No other problems developed during follow-up. Conclusion: Hyalomatrix$^{(R)}$ provides protective and favorable environment for wound healing. The combination of the use of Hyalomatrix$^{(R)}$ and the skin graft will be a good alternative for the ACC patients with relatively large defect on vertex.