• Title/Summary/Keyword: bone flap

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Anterior maxillary defect reconstruction with a staged bilateral rotated palatal graft

  • Jung, Gyu-Un;Pang, Eun-Kyoung;Park, Chang-Joo
    • Journal of Periodontal and Implant Science
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    • v.44 no.3
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    • pp.147-155
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    • 2014
  • Purpose: In the anterior maxilla, hard and soft tissue augmentations are sometimes required to meet esthetic and functional demands. In such cases, primary soft tissue closure after bone grafting procedures is indispensable for a successful outcome. This report describes a simple method for soft tissue coverage of a guided bone regeneration (GBR) site using the double-rotated palatal subepithelial connective tissue graft (RPSCTG) technique for a maxillary anterior defect. Methods: We present a 60-year-old man with a defect in the anterior maxilla requiring hard and soft tissue augmentations. The bone graft materials were filled above the alveolar defect and a titanium-reinforced nonresorbable membrane was placed to cover the graft materials. We used the RPSCTG technique to achieve primary soft tissue closure over the graft materials and the barrier membrane. Additional soft tissue augmentation using a contralateral RPSCTG and membrane removal were simultaneously performed 7 weeks after the stage 1 surgery to establish more abundant soft tissue architecture. Results: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppuration were not observed in the donor or recipient sites after the stage 2 surgery. These procedures enhanced the alveolar ridge volume, increased the amount of keratinized tissue, and improved the esthetic profile for restorative treatment. Conclusions: The use of RPSCTG could assist the soft tissue closure of the GBR sites because it provides sufficient soft tissue thickness, an ample vascular supply, protection of anatomical structures, and patient comfort. The treatment outcome was acceptable, despite membrane exposure, and the RPSCTG allowed for vitalization and harmonization with the recipient tissue.

Immediate implant placement and provisionalization of single implant in the esthetic region : Cases report (심미적 영역에서 즉시 임플란트 식립 및 임시 수복을 통한 단일치의 수복에 대한 증례 보고)

  • Lee, Song-Bea;Park, Yu-Seon;Kim, Byoung-Heon;Lee, Bo-Ah;Choi, Seong-Ho;Kim, Young-Taek
    • The Journal of the Korean dental association
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    • v.58 no.2
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    • pp.83-92
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    • 2020
  • In the anterior maxillary area, dental implants for tooth replacement are challenging due to the need to satisfy high esthetic level as well as functionality. Immediate implant placement and provisionalization can dramatically reduce the edentulous period, and then fulfill patient's demand for esthetics. The aim of present case report is to demonstrate two cases that successfully restored single tooth with immediate implant placement and provisionalization in the anterior maxillary area. A 47 years old female was scheduled to replace her maxillary right central incisor due to crown-root fracture by trauma. Another 54-year-old female was planned to place dental implant following tooth extraction of maxillary right lateral incisor owing to continuous pus discharge despite repetitive treatments including apicoectomy. In these two cases, surgical and prosthetic procedures progressed in a similar way. After minimal flap elevation, atraumatic tooth extraction was performed. Implant was placed in proper 3-dimensional position and angulation with primary stability. Bone graft or guided bone regeneration for peri-implant bone defect was conducted simultaneously. Provisionalization without occlusal loading was carried out at the same day. Each definitive crown was delivered at 7 and 5 months after the surgery. Two cases have been followed uneventfully for 2 to 5 years of loading time. In conclusion, Immediate implant placement and provisionalization could lead to esthetic outcome for single tooth replacement with dental implant under proper case selection.

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The effects of composit grafts of allogenic decalcified freeze Dried bone and calcium sulfate on the healing of 1-wall intrabony defects in dogs (성견의 1면 골내낭에서 탈회 냉동 건조골과 calcium sulfate 혼합이식이 치주조직 치유에 미치는 영향)

  • Suh, Jong-Jin;Choi, Seong-Ho;Cho, Kyoo-Sung;Chai, Jung-Kiu
    • Journal of Periodontal and Implant Science
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    • v.28 no.2
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    • pp.249-264
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    • 1998
  • The present study evaluates the effects of calcium sulfate and DFDB on alveolar bone regeneration and cementum formation and connective tissue adhesion in intrabony angulated 1 wall defects of dogs. Four millimeter-deep angulated one-wall intrabony defects were surgically created in the mesial & distal aspects of premolars and with flap operaion alone(control group), with calcium sulfate(experimental group 1), with composit graft of 50% calcium sulfate and 50% DFDB(experimental group 2), with DFDB alone(experimental group 3). Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of connective tissue adhesion was $1.05{\pm}0.48mm$ in the control, $1.30{\pm}0.67mm$ in the test group I, $0.97{\pm}0.22mm$ in the test group II and $0.93{\pm}0.15mm$ in the test group III. There was no statistical significance between control and all experimental groups. 2. Changes in alveolar bone level was $0.97{\pm}0.27mm$ in the control group, $1.45{\pm}0.42mm$ in the test group I, $2.00{\pm}0.33mm$ in the test group II, $1.88{\pm}0.34mm$ in the test group III. There was no statistically significant difference between control and experimental group I. There was a statistically significant difference between the control and experimental group II,III.(p<0.05). There was no statistically significant difference between all experimental group. 3. Cementum formation was $1.13{\pm}0.17mm$ in the control, $1.78{\pm}0.31mm$ in the test group I, $2.17{\pm}0.38mm$ in the test group II, $2.15{\pm}0.47mm$ in the test group III with statistically significant differences between control group and all experimental group(P<0.05). There was no statistically significant differences between all experimental group. These results suggest that the use of composit graft of 50% calcium sulfate and 50% DFDB and DFDB alone in angulated 1 wall intrabony defects has little effects on connective tissue adhesion, but has significant effects on new bone and new cementum formations.

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Clinical Application of Image Guided Surgery : Zeiss SMN System (영상유도 뇌수술 장비의 임상적 적용 : Zeiss SMN System)

  • Lee, Chea Heuck;Lee, Ho Yeon;Whang, Choong Jin
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.72-77
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    • 2000
  • The authors describe the experience with the interactive image-guided Zeiss SMN system, which has been applied to 20 patients with various intracranial lesions during one year. Preoperative radiologic evaluation was CT scan in 6 cases, MRI in 14 cases. In all except one case, average fiducial registration errors were less than 2mm. There was no statistical difference in registration error between CT and MR image. This system considered to be relatively stable with respect to soft and hardware. Also it was useful for the designing of the scalp incision and bone flap and assessing the extent of resection in tumors, especially in gliomas. Moreover, it was helpful to evaluate complex surgical anatomy in skull base surgery.

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Melanin Pigmentation In Gingiva (멜라닌 색소 침착의 치료)

  • Lee, In-Kyeong;Han, Soo-Boo
    • Journal of Periodontal and Implant Science
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    • v.33 no.2
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    • pp.271-276
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    • 2003
  • Oral melanin pigmentation is common in some races and ethnic groups. The gingivae are the most frequently pigmented intra-oral tissues. Melanin pigmentation is the result of melanin granules, produced by melanoblasts intertwined between epithelial cells at the basal layer of the epithelium. We present one case of melanin pigmentation of the gingiva of 26-year old female. Melanin depigmentation method is applying a 90% phenol solution to deepithelize pigmented areas, gingivectomy, epithelial abrasion, bone denudation, and split thickess flap. We chose epithelial abrasion using round diamond bur. The patient satisfies the result and have almost no pain and discomfort. But repigmentation potential must be noticed to patient.

In Situ Floating Resin Cranioplasty for Cerebral Decompression

  • Ahn, Duck-Hyung;Kim, Dae-Won;Kang, Sung-Don
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.417-420
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    • 2009
  • The purpose of this report is to describe our surgical experiences in the treatment of cerebral decompression with in situ floating resin cranioplasty. We included in this retrospective study 7 patients who underwent in situ floating resin cranioplasty for cerebral decompression between December 2006 and March 2008. Of these patients, 3 patients had traumatic brain injury, 3 cerebral infarction, and one subarachnoid hemorrhage due to aneurysmal rupture. In situ floating resin cranioplasty for cerebral decompression can reduce complications related to the absence of a bone flap and allow reconstruction by secondary cranioplasty without difficulty. Furthermore, it provides cerebral protection and selectively eliminates the need for secondary cranioplasty in elderly patients or patients who have experienced unfavorable outcome.

Disseminated Intravascular Coagulation in a Patient Undergoing Removal of Metastatic Brain Tumor

  • Eom, Ki-Seong;Kim, Jong-Moon;Kim, Tae-Young
    • Journal of Korean Neurosurgical Society
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    • v.44 no.5
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    • pp.341-344
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    • 2008
  • The authors present a case of 68-year-old woman who underwent resection of a metastatic adenocarcinoma in the left parietooccipital area. The intraoperative course was uneventful; however, after closure of the scalp incision, increased bleeding from the suture line was noted. A computerized tomography scan that was performed immediately after operation revealed acute epidural hemorrhage with mass effect under the bone flap. The patient developed disseminated intravascular coagulation and immediate re-exploration was performed. This patient was successfully treated owing to early recognition of the condition and immediate treatment with transfusion. Neurosurgeons should be alert that hypercoagulabe state is common in cancer patients and consumptive coagulopathy can occur after resection of metastatic brain tumor.

Temporomandibular joint reconstruction using autogenous tissue (임상가를 위한 특집 3 - 자가 조직이식을 통한 턱관절 재건)

  • Lee, Jong-Ho;Lee, Jung-Woo;Lee, Jin-Yong;Kim, Soung-Min;Kim, Myung-Jin
    • The Journal of the Korean dental association
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    • v.50 no.5
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    • pp.262-269
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    • 2012
  • TMJ reconstruction is one of the most challenging surgical treatment, and many methods using autogenous and alloplastic materials have been reported for making neocondyle. Although alloplastic materials which include aclylic, synthetic and total joint system are recently widely used, many surgeons agree that autogenous TMJ reconstruction is gold standard until now. In this article, classification of the TMJ defects and the various TMJ reconstruction methods using autogenous source were introduced with review of literature.

Rare Cleft of the Nose (코에 국한된 희귀 안면 갈림)

  • Lee, Jung Ho;Song, Jin Kyung;Byeon, Jun Hee
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.667-670
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    • 2005
  • Congenital facial cleft is a rare entity and appears along by the line of different processes of the facial development. An isolated cleft of the nose has been reported not often in the literature. We treated a patient with an isolated nasal cleft associated with undefined cranial anomaly. On 3D CT scan was seen a bony cleft traversing the pyriform aperture lateral to the anterior nasal spine. The nasal septum and frontal process of the maxilla were intact. There also was found bilateral bony defects in the frontal bone and bilateral frontal boss. The nasal cleft and frontal defect and boss were corrected by two stages: anterior two-third of the cranial vault with bilateral frontal boss was remodeled at the age of two years and the nasal cleft was repaired with a local rotation flap at age 3.