• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.257-277
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• 2000

New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration are basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, and biological mediators. Platelet Rich Plasma has been reported as a biological mediator which regulates activities of wound healing progress including cell proliferation, migration, and metabolism. The purpose of this study is to evaluate the effects of using the Platelet Rich Plasma as a regeneration promoting agent for furcation involvement defect. Five adult beagle dogs were used in this experiment. The dogs were anesthetized with Ketamin HCl(0.1 ml/kg, IV)and Xylazine hydrochloride($Rompun^{(R)}$, Bayer, 0.1 ml/kg, IM) and conventional periodontal prophylaxis were performed with ultrasonic scaler and hand instruments. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree II furcation defect was made on mandibular third(P3), forth(P4) and fifth(P5) premolar, and stopping was inserted. After 4 weeks, stopping was removed, and bone graft was performed. Ca-P was grafted in P3(experimental group I), Combination of Ca-P and plasma rich platelet were grafted in P4(experimental group II), and P5 was remained at control group.Systemic antibiotics(gentamicin sulfate)and anlgesics(phenyl butazone) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operate sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 4, 8 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. At 4 weeks after surgery, there were rapid osteogenesis phenomenon on the defected area of the Platelet Rich Plasma plus Ca-P BBP group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. In conclusion, Platelet Rich Plasma can promote rapid osteogenesis during healing of periodontalregeneration.

• Archives of Reconstructive Microsurgery
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• v.7 no.2
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• pp.135-145
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• 1998

In 1980 Morrison and O'Brien reported their experiences about the reconstruction of amputated thumb using wrap-around neurovascular free flap from the great toe with a nonvascularized iliac bone graft. From then it has been considered to be a good reconstructive procedure for the amputated thumb, but it's indication has been limited distal to the metacarpophalangeal(MP) joint. We have performed 37 cases of wrap-around free flap from the great toe for the reconstruction of thumb amputated at distal or proximal to the MP joint and investigated their functional results according to the level of amputation. Level of amputation was distal to the MP joint in 25 cases and proximal to it in 12 cases. Pinching and grasping power, two point discrimination and the amount of opposition to the other fingers were compared to the uninjured hand. Pinching and grasping power were not significantly different according to the level of amputation but the amount of two point discrimination was significantly high in the cases amputated proximal to the MP joint. The opposition of reconstructed thumb to the other fingers was completely possible in all cases amputated distal to the MP joint. In 12 cases amputated proximal to the MP joint of the thumb, opposition was completely possible in 6 cases in which the iliac bone block was fixated in the position of $30^{\circ}$ flexion and $45^{\circ}$ internal rotation but in 6 cases in the fixation of $30^{\circ}$ flexion and $30^{\circ}$ internal rotation, the opposition of reconstructed thumb to the ring and little fingers were impossible in 5 cases and only to the little finger in 1 case. In this study, we concluded that even if amputation proximal to the MP joint, it is no more contraindication of the wrap-around free flap procedure for thumb reconstruction, however in these cases we recommend iliac bone block fixation in the position of $30^{\circ}$ flexion and $45^{\circ}$ infernal rotation for the better functional outcome.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.5
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• pp.288-294
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• 2016

Chondrosarcoma is a malignant tumor that originates from cartilaginous cells and is characterized by cartilage formation. Only 5% to 10% of chondrosarcoma occurs in the head and neck area, and it is uncommon in the temporomandibular joint area. This report describes an unusual case with a rare, large chondrosarcoma in a 47-year-old woman who presented with painless swelling and trismus. Computed tomography showed a large mass approximately $8.5{\times}6.0$ cm in size arising adjacent to the lateral pterygoid plate and condyle. There were features suggestive of bone resorption. The tumor was resected in a single block with perilesional tissues, and a great auricular nerve graft was performed because of facial nerve sacrifice. Microscopic examination of sections stained with H&E revealed chondrocytes with irregular nuclei and heterogeneous hyper chromatic tumor cells embedded in the chondrocyte lacuna. The diagnosis was a grade I chondrosarcoma. There was no evidence of recurrence at the 8-month follow-up, and a reconstruction surgery with fibular osteocutaneous free flap was performed. We report this unusual entity and a review of the literature.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.535-563
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• 1993

New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration alre basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet-derived growth factor (PDGF) is one of polypeptide growth factor. PDGF have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purposes of this study is to evaluate the possibility of using the PDGF as a regeneration promoting agent for furcation involvement defect. Eight adult mongrel dogs were used in this experiment. The dogs were anesthetized with Pentobarbital Sodium (25-30 mg/kg of body weight, Tokyo chemical Co., Japan) and conventional periodontal prophylaxis were performed with ultrasonic scaler. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree III furcation defect was made on mandibular second(P2) and fourth(P4) premolar. For the basic treatment of root surface, fully saturated citric acid was applied on the exposed root surface for 3 minutes. On the right P4 20ug of human recombinant PDGF-BB dissolved in acetic acid was applied with polypropylene autopipette. On the left P2 and right P2 PDGF-BB was applied after insertion of ${\beta}-Tricalcium$ phosphate(TCP) and collagen (Collatape) respectively. Left mandibular P4 was used as control. Systemic antibiotics (Penicillin-G benzathine and penicillin-G procaine, 1 ml per 10-25 1bs body weight) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operated sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 2, 4, 8, 12 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. At 2 weeks after surgery, therer were rapid osteogenesis phenomenon on the defected area of the PDGF only treated group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. New cementum fromation was observed from 2 weeks after surgery, and the thickness was increased until 8 weeks with typical Sharpey’s fibers reembedded into new bone and cementum. In both PDGF-BB with TCP group and PDGF-BB with Collagen group, regeneration process including new bone and new cementum formation and the group especially in the early weeks. It might be thought that the migration of actively proliferating cells was prohibited by the graft materials. In conclusion, platelet-derived growth factor can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

• Korean Journal of Cleft Lip And Palate
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• v.3 no.1
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• pp.1-9
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• 2000

목적 : 치조파열 환자에 있어서 이차 치조골 이식술을 시행한 후 그 결과를 알아보고자 방사선학적 분석을 통하여 평가하였다. 본 연구의 목적은 수술전 골결손부 인접치아의 치조정 높이와 수술후 골결손부 인접치아의 치조정 높이를 근심측과 원심측에서 각각 측정함으로써 치조정의 높이가 과연 통계적으로 유의성 있게 증가하는지와 치조골 이식술의 성공률이 치조열의 너비와 상관관계가 있는지의 여부를 알아보는 것이다. 환자 및 방법 : 1991년부터 1999년까지 서울대학교병원 구강악안면외과에서 자가장골 채취 후 분쇄피질망사골 형태 또는 block 피질망상골 형태로 이식한 편측성 치조열을 가진 환자 중 최소한 6개월이 경과한 환자 56명을 연구대상으로 하였고 두 술자에 의해 시술되었다. 수술전 골결손부 인접치아의 치조정의 높이와 치조열의 너비 및 수술후 이식한 골의 높이와 절흔의 양은 치과용 파노라마 방사선 사진을 이용하여 측정하였고, 치조열의 너비는 모델이나 환자의 골결손부 근심치아의 근원심 폭경을 이용하여 환산하였다. 그리고 이식한 골의 높이와 절흔의 양을 1995년 Long이 제시한 방법으로 측정하여 술전의 측정치와 비교하였다. 결과 : 치조열의 너비는 평균 6.9mm(1.9mm-12.1mm) 였다. 근심에서의 치아는 골이식 당시 중절치가 52개(92.9%), 측절치가 4개(7.1%)였고, 49명의 환자에서 완전맹출을, 6명의 환자에서 부분맹출(측절치 2개, 중절치 4개)을 보였다. 원심측에서의 치아는 골이식 당시 측절치가 25개(44.6%), 견치가 29개(51.8%), 소구치가 2개(3.6%)였고, 완전 맹출이 32.1%, 부분 맹출이 57.2%, 미맹출이 10.7%로서 완전히 맹출하기 전에 골이식한 경우가 67.9%였다. 모든 환자에 있어서 bony bridge가 나타났고, 절흔이 인접치 아래로 연장되지 않았으며, 치조골 이식술 후 oronasal fistula를 보인 환자는 한 명도 없었으므로 성공률은 100%였다. 술후 근심측에서의 치조정의 높이는 근심측 치아 치근길이의 79%(평균), 원심측에서의 치조정의 높이는 원심측 치아 치근길이의 87%(평균)로서 통계적으로 유의성 있게 증가하였다. 결론: 이차 치조골 이식술을 시행한 후 치조정의 높이는 골결손부 근심측과 원심측에서 모두 유의성있게 증가하였고, 근심측에서보다 원심측에서 통계학적으로 더 유의성 있게 증가하였다. 치조열의 너비와 절흔의 양, 치조정의 높이 및 치조골이식 성공률과는 유의성 있는 관련성이 없었다.