• Journal of Periodontal and Implant Science
• /
• v.44 no.2
• /
• pp.94-99
• /
• 2014

Purpose: Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the longterm outcome of this grafted gingiva. Methods: A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap. Results: At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue. Conclusions: Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.

• Archives of Plastic Surgery
• /
• v.33 no.1
• /
• pp.101-106
• /
• 2006

Nipple reconstruction is an important step in breast reconstruction after mastectomy. The authors' preferred reconstructive technique is the local C-V flap in case that a small opposite nipple is not adequate for composite graft. This flap produces an excellent reconstruction, but it is not easy to produce an adequate projection and firmness of the nipple. This article describes the technique and experience in nine patients treated over two years with dermis(scar tissue) graft for nipple reconstruction. This is the first report of application of autologous dermis(scar tissue) grafting to reconstruct a nipple primarily after breast mound reconstruction, decreasing the absorption of the reconstructed nipple and increasing the hardness. The dermis(scar tissue) is taken from scar revision and/or dog-ear correction in the second stage operation after free TRAM flap breast reconstruction. And the dermis(scar tissue) graft is inserted vertically between the local flaps and horizontally under the reconstructed nipple base. Between September 2002 and February 2005, nine patients underwent C-V flap with dermis(scar tissue) graft as a part of their nipple reconstruction. The patient's ages ranged from 28 to 55 years old (mean, 41.1 years old). The follow-up period ranged from 5 to 35 months, with an average of 14.5 months. None of the nipples showed skin flap necrosis or local infection, and uneventful wound healing. Our result showed good nipple projection with less absorption and enough firmness. Our experiences shows that dermis(scar tissue) grafts in C-V flap is a very useful method for nipple reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.3
• /
• pp.348-352
• /
• 1996

Soft tissue defects in oral & maxillofacial region caused by tumor resection, trauma, congenital deformities have been treated in autogenous soft tissue flap, allogenic material, free dermal graft, fascia graft. Of these methods, autogenous dermis graft had initially been applied in hernia treatment at the beginning of nineteenth century and have been applied in soft tissue augmentation coverage of vital structure, dead space removal and reconstruction of fascia. A fat graft is used in reconstruction of orbit at the enucleation, restoration of facial contours, etc. In this case, patient with chin soft tissue defect in traffic accident was treated in autogenous dermis-fat graft from patient's abdominal and gluteal region. Chin defect was reconstructed favorably. There was no severe atrophy of grafted area 12 months postoperatively. We will report the result that is favorable esthetically with literature review.

• Journal of Environmental Science International
• /
• v.12 no.2
• /
• pp.119-124
• /
• 2003

An effective grafting method for jujube nursery trees was developed to shorten the operation time, improve the percentage of "takes" and shoot emergence, and form the better graft union. Out of 7 grafting methods the splice, modified scion Ono graft and the bark graft showed relatively short operation time during the grafting operation comparing to the modified rootstock Ono graft or the chip budding. Among these methods, the bark graft demonstrated 100% "takes", but the modified scion Ono graft or the standard Ono graft showed 58.3% of "takes". The percentages of the vegetative shoot emergence were 100% fir the bark graft, 70% f3r the modified scion Ono graft and lower emergence percent for the rest grafting methods. The union tissue formation for the modified scion Ono graft, the bark graft, or the whip-and-tongue graft was significantly larger than the standard Ono graft or the splice graft. In a close examination of the cross sectional areas of the graft union formation through the microscope, the bark graft was superior, the standard Ono graft was inferior and rest of the grafting methods were intermediate.ing methods were intermediate.

• Journal of Periodontal and Implant Science
• /
• v.42 no.3
• /
• pp.105-109
• /
• 2012

Purpose: Soft tissue recessions frequently cause esthetic disharmony and dissatisfaction. Compared with soft tissue coverage around a tooth, the coverage of an implant site is obviously unpredictable. Particularly in the cases of thin mucosa, a significant greater amount of recession takes place compared to thick mucosa. To overcome this problem, this case report demonstrates a two-step mucosal dehiscence coverage technique for an endosseous implant. Methods: A 33-year-old female visited us with the chief complaint of dissatisfaction with the esthetics of an exposed implant in the maxillary left cental incisor region. A partial-thickness pouch was constructed around the dehiscence. A subepithelial connective tissue graft was positioned in the apical site of the implant and covered by a mucosal flap with normal tension. At 12 months after surgery, the recipient site was partially covered by keratinized mucosa. However, the buccal interdental papilla between implant on maxillary left central incisor region and adjacent lateral incisor was concave in shape. To resolve the mucosal recession after the first graft, a second graft was performed with the same technique. Results: An esthetically satisfactory result was achieved and the marginal soft tissue level was stable 9 months after the second graft. Conclusions: The second graft was able to resolve the mucosal recession after first graft. This two-step approach has the potential to improve the certainty of esthetic results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.6
• /
• pp.565-580
• /
• 2000

This study was designed to evaluate the influence of cultured epidermal tissue graft and the administration of transforming growth factor(TGF)-${\beta}_3$ on maxillary growth in surgically created palatal defects. A total of 155 rats were divided into 2 groups according to surgical timing : postnatal 2 weeks(n=95), 4 weeks(n=40) and control(unoperated) group(n=20). The postnatal 2-week surgical group was subdivided into 3 groups according to repair methods: conventional surgery(Von Langenbeck technique)group(n=23); cultured tissue graft group(n=25); and full thickness skin graft group(n=25). Additionally, recombinant human TGF-${\beta}_3$ was administered(30ng or 150ng) on collagen matrix in surgically created palatal defects during surgery(9 conventional surgeries, 9 cultured tissue grafts) in 2-week-old rats. The results showed that all types of surgical treatment decreased maxillary growth compared with the control(unoperated) group(p<0.0001). On the other hand, the tissue graft group, whether cultured tissue or grafted skin, contributed to increased maxillary growth(p<0.0001).And exogenous TGF-${\beta}_3$ might play a role in connective tissue proliferation and new bone generation during wound healing on palatal defects. Our results suggest that grafting cultured epidermis with collagen matrix decreases the scar tension on maxillary growth more than conventional palatal surgery does. Therefore, exogenous TGF-${\beta}_3$ may contribute to accelerate wound healing on palatal defects.

• Journal of Periodontal and Implant Science
• /
• v.25 no.1
• /
• pp.146-152
• /
• 1995

A mucogingival grafting procedure has been developed to cover denuded root surfaces. The subepithelial connective tissue graft is composed of a free connective tissue graft and an overlying pedicle graft. The source of connective tissue graft were trap door approach and thining of a full thickness palatal flap. The purpose of this study was compare a two different connective tissue obtaining method. In this study, where palatal pocket was present, pocket elimination was performed, and the tissue normally discarded after thinning of the palatal flap was used as a grafting material. The results were as follows : 1. The mean difference between trap door approach and thinning procedure for root coverage were $2.1{\pm}O.lmm$, $2.2{\pm}O.2mm$. 2. The mean difference between trap door approach and thinning procedure for pocket depth change were $O.2{\pm}O.lmm$, $O.2{\pm}O.2mm$. 3. The mean difference between trap door approach and thinning procedure for attachment gain were $2.1{\pm}O.2mm$, $2.4{\pm}O.2mm$. 4. The esthetics in recipient site, both color match and tissue contour, were acceptable to the patient in all cases. 5. Therefore, thinning procedure were similar to trap door approach in root coverage effect.

• Journal of Periodontal and Implant Science
• /
• v.28 no.3
• /
• pp.409-418
• /
• 1998

The socket preservation technique is very effective in preventing alveolar ridge collapse after tooth extraction. Many technigues have been proposed for the primary closure of the flap and we tested a new graft design, "wing graft", which is a modification of free connective tissue graft in this case report. With this technique, primary closure was achieved without shallowing the vestibule. Additionally some vertical ridge augmentation effect could be observed and therefore good esthetic and functional results were obtained from this technique even in the case where severe bone loss and gingival recession was present. Finally we observed good healing appearance in the donor site after 2weeks. The results from this report suggest that this "wing graft" can be used successfully as an adjunctive procedure with socket preservation technique.

• 대한정형외과스포츠의학회:학술대회논문집
• /
• 2003.11a
• /
• pp.44-57
• /
• 2003

1) Choice of graft selection : depends on surgeon's philosophy & experience, tissue availability(anatomical anomalies, prior surgery or injury) & patient activity level & desiers. patients - educated as to potential advantage & disadvantages of each choice available to them. No one graft has been shown to be overwhelmingly superior to another. 2) High demand individual (cutting, pivoting, jumping sports, skiing) - BPTB graft choice Lower demand or older individuals - hamstring reconstruction Allograft : older individuals(45 years old) sign of arthritis(compelling evidence of instability) individual who do not want their own tissue Prosthetic ligaments - long term results : disappointing

• Journal of Periodontal and Implant Science
• /
• v.30 no.3
• /
• pp.651-661
• /
• 2000

A mucogingival grafting procedure has been developed to cover denuded root surface. The subepithelial connective tissue graft technique is very predictable and allows for a good esthetic results and minimum patient discomfort on the palate. However, in areas where there is a lack of vestibular depth and keratinized attached tissue, the presence of frena or heavy muscle attachment, covering the connective tissue graft with a mucosal flap is very difficult. The purpose of this study is to evaluate an alternative technique of root coverage using the free connective tissue graft. The results were as follows: 1. Probing depths didn't seem to vary significantly from the preoperative to postoperative period. 2. The amount of keratinized tissue showed an increase of $5.9{\pm}0.97mm$ from the preoperative level. 3. Total clinical exposed root coverage increase 72.2% compare with preoperative level. 4. The shrinkage from gingival margin is $4.2{\pm}1.15mm$ and the mean shrinkage rate is 40.1%. 5. The depth of the vestibule increased with the average distance from cementoenamel junction to mucogingival junction being $7.4{\pm}1.65mm$.