• Title/Summary/Keyword: Tissue graft

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CLINICAL EVALUATION OF CORALLINE BASED POROUS HYDROXYAPATITE AND CORALLINE BASED CALCIUM CARBONATE IN HUMAN INTRABONY PERIODONTAL LESIONS (Coralline Based Porous Hydroxyapatite와 Coralline Based Calcium Carbonate의 이식후 치조골내결손부에 대한 임상적 평가)

  • Shim, Jung-Min;Son, Seong-Heui;Han, Soo-Boo
    • Journal of Periodontal and Implant Science
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    • v.24 no.1
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    • pp.120-130
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    • 1994
  • The purpose of the present investigation was to compare the effectiveness of porous hydroxyapatite (PHA) and coralline based porous calcium carbonate(PCC) as implant materials in human periodontal osseous defects. 10 adult patients having periodontitis and 2 similar angular osseous defects ${\ge}$5mm as verified by radiographic analysis and clinical probing depth ${\ge}$4mm were selected. The measurements were recorded just before surgery and after 6 month. Clinical parameters used in this study included gingival recession, pocket depth, probing attachment level, Sulcus Bleeding Index, Plaque Index, tooth mobility and bone defect depth measurements. After initial therapy, patients were treated with mucoperiosteal flap surgery. The contralateral bony defects in each patient randomly assigned to either bone graft material, one with PHA(Interpore 200) and the other with coralline based calcium carbonate(Biocoral). After 6 month both groups showed statistically significant reduction of pocket depth, Sulcus Bleeding Index, Plaque Index and significant improvement in probing attachment level. No statistically significant differences were found between the groups. There were 3.0mm or 68% of bone repair with PHA and 3.1mm, 61% with PCC. These values were likewise not significantly different. The data and clinical impression strongly suggest that both PHA and PCC are alloplastic implants with clinically apparent acceptance by the soft and hard tissue and that they can be used as bone graft materials successfully.

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Reconstruction of a long defect of the median nerve with a free nerve conduit flap

  • Campodonico, Andrea;Pangrazi, Pier Paolo;De Francesco, Francesco;Riccio, Michele
    • Archives of Plastic Surgery
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    • v.47 no.2
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    • pp.187-193
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    • 2020
  • Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. During the postoperative period, the patient followed an intensive rehabilitation program and was monitored for functional performance over 5 years of follow-up. Our assessment demonstrated skin tropism and sufficient muscle power to act against strong resistance (M5) in the muscles previously affected by paralysis, as well as a good localization of stimuli in the median nerve region and an imperfect recovery of two-point discrimination (S3+). We propose a novel and efficient procedure to repair >10-cm peripheral nerve gap injuries related to upper limb trauma.

Osteosarcoma Arising from Desmoplastic Fibroma of Proximal Tibia - A Case Report - (근위 경골의 결합조직형성 섬유종 치료 후 발생한 골육종 - 1예 보고 -)

  • Kim, Tai-Seung;Park, Yong-Wook;Park, Moon-Hyang;Jang, Si-Hyong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.162-166
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    • 2007
  • Desmoplastic fibroma of bone is rare, involves usually long bones, and histologically resemblance to the desmoid tumor of soft tissue. It is benign, but aggressive locally. Recurrence rate is high when treated with simple curettage and bone graft. Moreover, malignant transformation of desmoplastic fibroma with recurrence has been reported very rarely, and then it make us review again whether previous tumor probably was low grade malignant tumor. We report a surgically proven case of osteosarcoma arising from desmoplastic fibroma. A 17 years old male had been treated for a desmoplastic fibroma of the proximal tibia with curettage and bone graft. But after 11 years, the patient showed recurrence accompanying malignant transformation with osteosarcoma. This is very rare case of an osteosarcoma arising in a desmoplatic fibroma of the proximal tibia.

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IN VITRO STUDY ON THE CYTOTOXICITY OF THE DIFFERENTLY STERILIZED DEMINERALIZED BONE POWDER (멸균방법에 따른 탈회동종골의 세포독성 여부에 관한 실험적 연구)

  • Woo, Ki-Sun;Yim, Chang-Joon;Kim, Se-Won;Kim, Jong-Yeo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.3
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    • pp.287-299
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    • 1997
  • Procurement, cutting, cleansing, freezing, freeze-drying, and demineralization of the allogeneic bone must be made under the germ-free stable condition without bacterial and/or viral contamination. Even thought the bone is procured under the germ free condition, we must have confidence on disinfection of all the solutions that come in contact with tissue during the whole procedure. Lots of antibacterial agents have been introduced for chemical sterilization. Recently ethylene oxide gas sterilization or radiation sterilization is frequently selected as a secendary sterilization procedure. The biological and biochemical response of the graft material differs with the type and concentration of the sterilizing agents, and various toxic reactions have been reported due to the graft material itself and the substance released by the chemicals. The authors conducted the Millipore filter test to observe the toxic effect on L929 fibroblasts according to the effect on activity of succinate dehydrogenase, during the secondary sterilization of the demineralized allogeneic bone powder with irradiation or ethylene oxide gas. The result were as follows : 1. Around the copper disk, positive control group, 10mm diameter discoloration was observed. 2. As same as the negative control group, the disk showed no discoloration. 3. The demineralized allogeneic bone which was sterilized with ethylene oxide gas or irradiation showed no cytotoxicity. 4. From this results, it is suggested that treatment with ethylene oxide gas or irradiation should be effective to sterilize the deminineralized allogeneic bone.

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A Comparative Study of the effects of Autogenous and Xenogenic Bone grafts with PRP(Platelet Rich Plasma) technique on Periodontal Regeneration (혈소판 농축 혈장과 혼합된 자가골 및 이종골 이식재가 치주 조직의 재생에 미치는 효과)

  • Kim, Dong-Gi;Lim, Sung-Bin;Chung, Chin-Hyung;Hong, Ki-Seok
    • Journal of Periodontal and Implant Science
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    • v.34 no.3
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    • pp.499-508
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    • 2004
  • Regeneration of Periodontium with PRP does not only improve regeneration rate and density of bone but have a possibility to estimate faster healing process for soft tissue. And also, autogenous bone and xenogenic bone graft are effective on regeneration of periodontium. The purpose of this study is to evaluate the effectiveness of autogenous bone and xenogenic bone $(BBP^{(R)})$ grafts with the PRP technique on regeneration of periodontium. 52 Generally healthy Pt. who had pocket depth 5mm at any of 6 surfaces of the teeth were in the study at Dept. of Perio. in Dankook Dental Hospital. Open Flap was treated for 18 infra-bony pockets as control group, autogenous bone with PRP was inserted for 25 infrabony pockets as first test group, and $(BBP^{(R)})$ with PRP was inserted for 22 infrabony pockets as 2nd test group. Then evaluation was made after 3 and 6 months 1. There were significant differences between average probing pocket depth and clinical attachment level of 3, 6 months and minimal and maximal attachment level after 6 months each other. 2. There were significant differences in average probing pocket depth of control group and 2nd experimental group between 1 and 6 months. For clinical attachment level and minimal and maximal proving attachment level, there was a significant difference after 6 month of surgery. 3. There was no significant difference between two test groups for average probing depth, clinical attachment level, and minimal and maximal probing attachment level. As the result, PRP with bone graft could be very effective for regeneration of periodontium and there was no difference between xenogenic bone and autogenous bone.

In vitro assay for osteoinductive activity of different demineralized freeze-dried bone allograft

  • Vaziri, Shahram;Vahabi, Surena;Torshabi, Maryam;Hematzadeh, Somayeh
    • Journal of Periodontal and Implant Science
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    • v.42 no.6
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    • pp.224-230
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    • 2012
  • Purpose: Various bone graft materials have been used for periodontal tissue regeneration. Demineralized freeze-dried bone allograft (DFDBA) is a widely used bone substitute. The current widespread use of DFDBA is based on its potential osteoinductive ability. Due to the lack of verifiable data, the purpose of this study was to assess the osteoinductive activity of different DFDBAs in vitro. Methods: Sarcoma osteogenic (SaOS-2) cells (human osteoblast-like cells) were exposed to 8 mg/mL and 16 mg/mL concentrations of three commercial types of DFDBA: Osseo+, AlloOss, and Cenobone. The effect of these materials on cell proliferation was determined using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay. The osteoinductive ability was evaluated using alizarin red staining, and the results were confirmed by evaluating osteogenic gene expression using reverse transcription polymerase chain reaction (RT-PCR). Results: In the SaOS-2 cells, an 8 mg/mL concentration of Osseo+ and Cenobone significantly increased cell proliferation in 48 hours after exposure (P<0.001); however, in these two bone materials, the proliferation of cells was significantly decreased after 48 hours of exposure with a 16 mg/mL concentration (P<0.001). The alizarin red staining results demonstrated that the 16 mg/mL concentration of all three tested DFDBA induced complete morphologic differentiation and mineralized nodule production of the SaOS-2 cells. The RT-PCR results revealed osteopontin gene expression at a 16 mg/mL concentration of all three test groups, but not at an 8 mg/mL concentration. Conclusions: These commercial types of DFDBA are capable of decreasing proliferation and increasing osteogenic differentiation of the SaOS-2 cell line and have osteoinductive activity in vitro.

RECONSTRUCTION COMBINED WITH HBO THERAPY AND ILIAC BONE GRAFT IN MANDIBULAR FRCTURE SITE OSTEOMYELITIS (하악골 골절후 이차감염으로 인한 골수염시 유리 장골 이식술과 고압산소 요법을 이용한 재건 치험례)

  • Kim, Su-Nam;Lee, Dong-kuen;Lim, Chang-Joon;Yun, Seong-Pill
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.110-116
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    • 1991
  • Fracture site osteomyelitis begins rarely with an acute event but rather has a subacute onset. It develops almost exclusively in the mandibular region. The treatment principles of mandibular fracture site osteomyelitis are complete removal of inflammatory tissue and drainage, rigid fixation with or without autogenous bone bone graft and specific antibiotic therapy. But hyperbaric oxygen used as a modality in the treatment of intractable osteomyelitis. In this paper, we reported that the three patients who have osteomyelitis accompying secondary in fection after mandibular fracture.

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Clinical and histopathological study on the effect of Nonresorbable membrane with Demineralized freeze dried bone graft for Guided Bone Regeneration in Implant Dehiscence Defects (매식체 주위 열개형 골결손부에서 차단막과 골 이식술의 사용이 골 형성에 미치는 영향에 대한 임상 및 조직병리학적 연구)

  • Kwon, Chil-Sung;Hong, Ki-Seok;Lim, Sung-Bin;Chung, Chin-Hyung;Lee, Chong-Heon
    • Journal of Periodontal and Implant Science
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    • v.35 no.3
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    • pp.687-702
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    • 2005
  • The purpose of this study is to examine the effect of non-resorbable membrane such as e-PTFE which was used with DFDB in bone regeneration on dehiscence defect in peri-implant area. Amomg the patients, who have recieved an implant surgery at the department of Periodontics in Dan Kook University Dental Hospital, 12 patients showed implant exposure due to the dehiscence defect and 15 implants of these 22 patients were the target of the treatment. Periodontists randomly applied $Gore-Tex^{(R)}$ to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 15 cases, 1 membrane exposure was observed and in this case, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area $9.25{\pm}4.84$ preoperatively and significantly increased to $11.48{\pm}7.52$ postoperatively(0.05). 4. The increase of bone surface area in non-resorbable membrane was $2.23{\pm}3.38$. 5. As a result of histopathological finding, DFDB surrounded by new bone formation and lamellate bone, resorption of DFDB and bone mineralization was found. Also, fibrosis of connective tissue beneath the membrane was found. This study shows that the surgical method using DFDB and non-resorbable membrane on dehiscence defect in peri-implant area is effective in bone regeneration.

Pain Relief and Accelerated Healing Processes of Wound by Low Level Laser Irradiation(Case Report) (저출력 레이저 조사에 의한 창상의 통증완화 및 치유조장 -증례 보고-)

  • Lee, Tae-Hyun;Sohn, Duk-Hee;Kim, Bong-Il;Cho, Sung-Kyeong;Lee, Sang-Hwa
    • The Korean Journal of Pain
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    • v.7 no.1
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    • pp.74-77
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    • 1994
  • Since its introduction, low level lasers have been utilized in many varied clinical applications for the treatment of musculoskeletal and body surface lesions. Due to the laser beams specific characteristic-coherence, monochromaticity and unidirectionality, without adverse reaction with neighbouring tissue, physicians have used it with relative ease. We observed accelerating effects of healing process of some intractable skin wound, improvement of graft survival, as well as reduction of pain on ulcerating tissues, by treating twice weekly with low level Helium-Neon(He-Ne) and Infrared(IR) laser. The laser's energy density was set at $1\;J/cm^2$ and a fixed frequency of 600 Hz by continuous scanning. Irradiating time was calculated according to the cross diameter of the wound. Further clinical work will be required to evaluate the accelerated healing processes by biostimulating mechanisms of laser ray, especially for the intractable(diabetic) skin ulceration.

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The Free Vascularized Groin Flap for the Reconstruction of Extremity (사지재건을 위한 서혜부 유리피부편 이식술)

  • Hahn, Soo-Bong;Park, Young-Hee;Kang, Ho-Jung
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.1-9
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    • 1998
  • From January 1985 to February 1997, 96 patients had undergone the free vascularized groin flap on the upper and lower extremities with microsurgical technique at the department of orthopaedic surgery, Yonsei University College of Medicine. The results were as follows: 1. Average age at the time of operation was 24.9 years. and there were 71 men and 25 women and mean follow up was 62.4 months. 2. The lesion site was 82 cases on the lower extremity: foot(40), leg(20), ankle(13), and 14 cases on the upper extremity: forearm(6), elbow(3), hand(3), wrist(2). 3. The anatomical classification of the superficial circumflex iliac artery was as follows: 1) 39.8% of common origin with superficial inferior epigastric artery, 2) 30.1% of isolated origin and absent superficial inferior epigastric artery, 3) 13.3% of separate origin, 4) 16.9% of origin from the deep femoral artery. 4. There was no statistical significance on arterial anastomosis between end to end and end to side, and on venous anastomosis(end to end) between one vein and two veins. 5. The success rate was average 84.4% in 81 of 96 cases. 6. In the 15 failed cases, the additional procedures were performed: 5 cases of free vascularized scapular flap, 6 cases of full thickness skin graft, 2 cases of cross leg flap, 1 case of latissimus dorsi flap, 1 case of split thickness skin graft. In conclusion, the free vascularized groin flap can be considered as the treatment of choice for the reconstruction of the extensive soft tissue injury on the extremities, and show the higher success rate with the experienced surgeon.

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