• Proceedings of the KSLP Conference
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• 2003.11a
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• pp.180-180
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• 2003

Objectives : Vocal fold augmentation by injectable material under direct visual control is an easy and simple operation. However, when autologous fat or bovine collagen is used, resorption creates a problem. And autologous fascia is debating about absorption now days. This study is to evaluate the histology of minced and injected autologous auricular cartilage and fat graft in the augmentation of unilateral vocal fold paralysis using a canine model. Methods : Nine dogs were operated. At first, a piece of auricular cartilage was harvested from ear and minced into tiny chips with a scalpel. And also, a piece of fat tissue was harvested from inguinal area and minced into tiny chips with a scalpel. Cutting off a section of the recurrent nerve paralyzed the right vocal fold. The minced cartilage and fat-paste (0.2ml) was injected using a pressure syringe into the paralyzed thyroarytenoid muscle under direct laryngoscopy. Two animals were sacrificed at 3 days, three at 3 weeks, two at 3 months, one at 6 months, one at 12 months. Each dog underwent laryngectomy and serial coronal sections of paraffin blocks from the posterior part of the vocal fold were made. Results : There was no significant complication perioperatively and during follow-up. There was acute inflammatory findings in the graft at 3 days and 3 weeks. The injected cartilage remained in the larynx until 12 months. Conclusion : The autologous auricular cartilage graft is well tolerated and may be very effective material for volumetric augmentation on paralyzed vocal cord.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.384-389
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• 2012

Background Numerous procedures are available for nipple reconstruction without a single gold standard. This study presents a method for reducing donor-site morbidity in nipple reconstruction using a composite nipple graft after transverse rectus abdominis musculocutaneous flap breast reconstruction. Methods Thirty-five patients who underwent nipple reconstruction using a composite nipple graft technique between July of 2001 and December of 2009 were enrolled in this study. To reduce the donor site morbidity, the superior or superior-medial half dome harvesting technique was applied preserving the lateral cutaneous branch of the fourth intercostal nerves. The patients were asked to complete a previously validated survey to rate the color and projection of both nipples, along with the sensation and contractility of the donor nipple; and whether, in retrospect, they would undergo the procedure again. To compare projection, we performed a retrospective chart review of all the identifiable patients who underwent nipple reconstruction using the modified top hat flap technique by the same surgeon and during the same period. Results Thirty-five patients were identified who underwent nipple reconstruction using a composite nipple graft. Of those, 29 patients (82.9%) responded to the survey. Overall, we received favorable responses to the donor site morbidity. Projection at postoperative 6 months and 1 year was compared with the immediate postoperative results, as well as with the results of nipples reconstructed using the modified top hat flap. Conclusions The technique used to harvest donor tissue is important. Preserving innervation of the nipple while harvesting can reduce donor site morbidity.

• Journal of Periodontal and Implant Science
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• v.47 no.1
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• pp.51-63
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• 2017

Purpose: Following tooth extraction, alveolar ridge preservation (ARP) can maintain the dimensions of ridge height and width. Although previous studies have demonstrated the effects of ARP, few if any studies have investigated the compressive force applied during grafting. The aim of this study was to determine the effects of different compressive forces on the graft materials during ARP. Methods: After tooth extraction, sockets were filled with deproteinized bovine bone mineral with 10% porcine collagen and covered by a resorbable collagen membrane in a double-layered fashion. The graft materials were compressed using a force of 5 N in the test group (n=12) and a force of 30 N in the control group (n=12). A hidden X suture was performed to secure the graft without primary closure. Cone-beam computed tomography (CBCT) was performed immediately after grafting and 4 months later, just before implant surgery. Tissue samples were retrieved using a trephine bur from the grafted sites during implant surgery for histologic and histomorphometric evaluations. Periotest values (PTVs) were measured to assess the initial stability of the dental implants. Results: Four patients dropped out from the control group and 20 patients finished the study. Both groups healed without any complications. The CBCT measurements showed that the ridge volume was comparably preserved vertically and horizontally in both groups (P>0.05). Histomorphometric analysis demonstrated that the ratio of new bone formation was significantly greater in the test group (P<0.05). The PTVs showed no significant differences between the 2 groups (P>0.05). Conclusions: The application of a greater compressive force on biomaterials during ARP significantly enhanced new bone formation while preserving the horizontal and vertical dimensions of the alveolar ridge. Further studies are required to identity the optimal compressive force for ARP.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.22.1-22.4
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• 2018

Background: Cross-facial nerve graft is considered the treatment of choice for facial reanimation in patients with unilateral facial palsy caused by central facial nerve damage. In most cases, a traditional parotidectomy skin incision is used to locate the buccal and zygomatic branches of the facial nerve. Methods: In this study, cross-facial nerve graft with the sural nerve was planned for three patients with facial palsy through an intraoral approach. Results: An incision was made on the buccal cheek mucosa, and the dissection was performed to locate the buccal branch of the facial nerve. The parotid papillae and parotid duct were used as anatomic landmarks to locate the buccal branch. Conclusions: The intraoral approach is more advantageous than the conventional extraoral approach because of clear anatomic marker (parotid papilla), invisible postoperative scar, reduced tissue damage from dissection, and reduced operating time.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.289-303
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• 2006

This study was performed to evaluate the effect of bone graft materials including demineralized freeze-dried bone, freeze-dried bone, deproteinized bovine bone on space-making capacity and bone formation in guided bone regeneration with titanium reinforced ePTFE membrane(TR-ePTFE). Adult male rabbits(mean BW 2kg) were used in this study. Intramarrow penetration defects were surgically created with round bur on calvaria of rabbits. TR-ePTFE membrane was adapted to calvarial defect and bone graft materials were placed. Animals were sacrificed at 2, 8, 12 weeks after surgery. Non-decalcified specimens were processed for histologic analysis and prepared with Villaneuva bone stain. The results of this study were as follows: 1. TR-ePTFE membrane was biocompatible and capable of maintaining the space-making. 2. Tissue integration was not good at TR-ePTFE membrane. Fixation was not enough. so, wound stabilization was not good. 3. In animals using deproteinized bovine bone, demineralized freeze-dried bone, bone formation was little. 4. In animals using freeze-dried bone, bone formation was better. Within the above results, bone formation may be inhibited when wound stabilizafion was not good.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.317-332
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• 2001

The purpose of this study was to investigate effects of the natural coral(NC) and the hydroxyapatite/calcium sulfate hemihydrate(HA/CS) on an early stages of wound healing in the rat periodontal fenestration defects. In this experiment, twelve male rats(Mean : 520g in BW) aged 8 to 9 months were used. Experimental periodontal fenestration defects were surgically created with tapered fissure bur at the buccal surface of the left mandibular 1st, 2nd molars. The buccal aspects of molar roots were carefully denuded of their periodontal ligament through a bony window created in the left mandibles of rats under general anesthesia. Each experimental periodontal fenestration defect was grafted with natural coral and HA/CS, randomly. An area without bone graft was assigned for negative control group. At 10,35 days, rats were serially sacrificed via intracardiac perfusion with 2.5% glutaraldehyde and specimens were processed with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows : 1. The defect areas were filled with dense connective tissues at 10 days in control group. But in the test(NC, HA/CS)groups, the connective tissues around graft materials were formed more loosely and the response of inflammation by graft materials itself was not found. 2. The defect areas were filled with new osteoid tissues and new cementum was not formed on the cut root surface at 35 days in the control group. 3. New osteoid tissue formation was more prominent at 35 days in control than test groups. 4. The NC and HA/CS particles were encapsulated by loose connective tissues at 10 days and by dense connective tissues at 35 days, respectively. 5. In the test groups, resorption of graft particles was not found through the experimental time. From the above results, natural coral and hydroxyapatite/calcium sulfate hemihydrate may be biocompatible and osteoconductive and have a weak adverse reaction to the periodontal tissues.

• Imaging Science in Dentistry
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• v.50 no.2
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• pp.93-98
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• 2020

Purpose: Little is known regarding the accuracy of clinical magnetic resonance imaging (MRI) protocols with acceptable scan times in sinus graft assessment. The aim of this study was to evaluate the correlations between MRI and cone-beam computed tomographic (CBCT) measurements of maxillary sinus grafts using 2 different clinical MRI imaging protocols. Materials and Methods: A total of 15 patients who underwent unilateral sinus lift surgery with biphasic calcium phosphate were included in this study. CBCT, T1-weighted MRI, and T2-weighted MRI scans were taken 6 months after sinus lift surgery. Linear measurements of the maximum height and buccolingual width in coronal images, as well as the maximum anteroposterior depth in sagittal images, were performed by 2 trained observers using CBCT and MRI Digital Imaging and Communication in Medicine files. Micro-computed tomography (micro-CT) was also performed to confirm the presence of bone tissue in the grafted area. Correlations between MRI and CBCT measurements were assessed with the Pearson test. Results: Significant correlations between CBCT and MRI were found for sinus graft height (T1-weighted, r=0.711 and P<0.05; T2-weighted, r=0.713 and P<0.05), buccolingual width (T1-weighted, r=0.892 and P<0.05; T2-weighted, r=0.956 and P<0.05), and anteroposterior depth (T1-weighted, r=0.731 and P<0.05; T2-weighted, r=0.873 and P<0.05). The presence of bone tissue in the grafted areas was confirmed via micro-CT. Conclusion: Both MRI pulse sequences tested can be used for sinus graft measurements, as strong correlations with CBCT were found. However, correlations between T2-weighted MRI and CBCT were slightly higher than those between T1-weighted MRI and CBCT.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.3
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• pp.207-215
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• 2009

Purpose: The aim of the present study is to evaluate the long term bone healing after horizontal ridge augmentation using auto block bone graft for implant installation timing. Materials and Methods: Five Beagle dogs(which were 14 months old and weighted approximately 10kg). In surgery 1(extraction & bone defect), premolars(P2, P3,P4) were extracted and the buccal bone plate was removed to create a horizontally defected ridge. After three months healing, in surgery 2(ridge augmentation). Auto block bone grafts from the mandibular ramus were used in filling the bone defects were fixed with stabilizing screws. The following fluorochrome labels were given intravenously to the beagle dogs: oxytetracycline 1week after the surgery, alizarin red 4 weeks after the surgery, calcein blue 8 weeks after the surgery. The tissue samples were obtained from the sacrificed dogs of 1, 4, 8, 12, 16 weeks after the surgery. Non-decalcified sections were prepared by resin embedding and microsection to find thickness of $10{\mu}m$ for the histologic examination and analysis. Results: 1. We could achieve the successful reconstruction of the horizontal bone defect by auto block bone graft. The grafted bone block remained stable morohologically after 16 weeks of the surgery. 2. In the histologic view. We observed osteoid tissue from the sample $4^{th}$ week sample and active capillary reconstruction in the grafted bone from the $12^{th}$ week sample. Healing procedures of auto bone grafts were compared to that of the host bone. 3. Bone mineralization could be detected from the $8^{th}$ week sample. 4. Fluorochrome labeling showed active bony changes and formation at the interface of the host bone and the block graft mainly. Bony activation in the grafted bone could be seen from the $4^{th}$ week samples. Conclusions: Active bone formation and remodeling between the grafted bone and host bone can be seen through the revascularization. After the perfect adhesion to host bone, Timing of successful implant installation can be detected through the ideal ridge formation by horizontal ridge augmentation.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.836-843
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• 1996

Histologic, and scanning electron microscopic observa ions were made of 12 biopsy specimens from polytetrdiluoroethylene (PTFE) grafts that had been Implanted as systemic-pulmonAry shunt for improving oxygenation of cyanotic congenital heart disease and harvested near the end of pulmonary artery side at the time of redo shunt or tonal correction between 1985 and 1992. The types of shunt operation are modified Blalock-Taussig shunt in 10 cases, Waterston-Cooley shunt in 1 And Potts shunt in 1 case. The 5 mm PTFE graft was used In 10, 4mm in 1 and 6mm in 1 case. The mean duration of implantalion was 0 $\pm$ 14.1 months(rl.on 12 months to 55 months). The plAtelets were aggregated between gaps'of Coretex surface and intimal thickening was noted about 10 to 20 months after implantation. Endothelial cells were found in the 40-months patent PTFE graft by light and scanning electron microscopy. In the specimen of poor flow or zero flow graft, severe intimal hyperplasia and thrombi which was made of platelets were noted . Based on this experience, we think that the patency will be maintained well if the connective tissue could be Hxed firmly over the Inner layer of the Goretex and the endothelial cell layer sllould form over the con- nective tissue and platelet aggregation should be prevented.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.189-196
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• 1992

Pre-surgical and post-surgical change in adult cleft lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft site in dental radiograph and then the prosthetic treatement to the missing teeth was done.