• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.1
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• pp.55-59
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• 2013

In the oral and maxillofacial area, bone defects are created by various reasons and demand for bone grafts, while dental implant implantation has been increased consistently. To solve these problems, there has been development of autogenous tooth-bone graft material (AutoBT$^{(R)}$, Korea Tooth Bank Co., Korea), and we have collected ground reasons to substitute free autobone graft with this material in clinical use. This autogenous tooth-bone graft material is produced in powder type and block type. Block type is useful in esthetic reconstruction of the defect site and vertical and horizontal augmentation of alveolar bone because this type has high strength value, well maintained shape and is less absorbed. Therefore, the author of this study gained favorable result by grafting the block type autogenous tooth-bone graft material after dental implant implantation on the bone defects of the mandibular molar extraction site. Moreover, the author represents this case with literature review after confirming bone remodeling on the computed tomography image and by histological analysis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.44-48
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• 2011

Maxillary defects are inherently complex because they generally involve more than one midfacial component. In addition, most maxillary defects are composite in nature, and often require bony support, as well as a mucosal lining for reconstruction. Therefore, midfacial bone and soft tissue defects present a unique challenge because they require a complex arrangement of tissues in a relatively limited space. This might be difficult to achieve only with free osteocutaneous flaps. The use of bone grafts allows greater flexibility in a reconstruction but is limited by graft resorption. We report a case of a patient reconstructed with a lateral arm free flap, iliac bone graft, sagital split ramus osteotomy for the reconstruction of a right maxillary defect zygomatico-maxillary defect caused by a zygomatico-maxillary malignant tumor resection.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.5
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• pp.419-424
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• 2009

Odontogenic myxoma, a rare tumour that occurs in the jaws, locally invasive, destructive tumors that do not metastasize to lymph nodes. Large odontogenic myxoma on mandible is treated by mandibulectomy, defected mandible is reconstructed by bone graft. Reconstructed mandible is difficult to reconstruct dentition using implant because of deficiency of bone amount. So it is necessary to additional bone graft. But a poor aspect of soft tissue lead to unsatisfactory result. Because of distraction osteogenesis is possible to reconstruction of an amount of bone and soft tissue, that is advantage to reconstruction of alveolar bone on reconstructed mandible. We report with review of literatures the 25 years old male patient who had odontogenic myxoma in left mandible, was undergone mandibulectomy and successfully implant installation and prosthetic restoration after distraction osteogenesis(Track $Plus^{(R)}$, KLS Martin, Germany) on the reconstructed mandible with a free iliac bone graft, and we have conservative and successful result.

• Journal of Rhinology
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• v.25 no.2
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• pp.123-129
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• 2018

Background and Objectives: Endoscopic repair of cerebrospinal fluid (CSF) leak can avoid morbidity of open approaches and has shown a favorable success rate. Free mucosal graft is a good method, and multi-layered repair is more favorable. The inferior turbinate has been commonly utilized for the free mucosal graft, but we newly designed it as a bone-periosteal-mucosal composite graft for multilayered reconstruction. Subjects and Method: Four subjects with a skull base defect were treated with this method. The inferior turbinate was partially resected including the conchal bone and was trimmed according to defect size. Both bony parts and periosteum were preserved on the basolateral side of the mucosa as a composite graft. The graft was applied to the defect site using an overlay technique. Results: All cases were successfully repaired without any complications. Three of them had a defect size greater than 10-12 mm, and the graft stably repaired the CSF leakage. Conclusion: Endoscopic repair of CSF leakage using inferior turbinate composite graft is a simple and easy method and would be favorable for defect sizes greater than 10 mm.

• Archives of Plastic Surgery
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• v.43 no.1
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• pp.3-9
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• 2016

The reconstruction of the mandible is a complex procedure because various cosmetic as well as functional challenges must be addressed, including mastication and oral competence. Many surgical techniques have been described to address these challenges, including non-vascularized bone grafts, vascularized bone grafts, and approaches related to tissue engineering. This review summarizes different modifications of the free vascularized fibula graft, which, since its introduction by Hidalgo in 1989, has become the first option for mandibular reconstruction. The fibula free flap can undergo various modifications according to the individual requirements of a particular reconstruction. Osteocutaneous flaps can be harvested for reconstruction of composite defects. 'Double-barreling' of the fibula can, for instance, enable enhanced aesthetic and functional results, as well as immediate one-stage osseointegrated dental implantation. Recently described preoperative virtual surgery planning to facilitate neomandible remodeling could guarantee good results. To conclude, the free fibula bone graft can currently be regarded as the "gold standard" for mandibular reconstruction in case of composite (inside and outside) oral cavity defects as well as a way of enabling the performance of one-stage dental implantation.

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

• 대한미세수술학회:학술대회논문집
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• 1995.11a
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• pp.78.1-78.1
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• 1995

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.42-49
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• 2005

Between June 1989 and may 2004 Ipsilateral vascularized fibular transposition was performed on nine patients with segmental tibial defects combined with infection following trauma. Ipsilateral vascularized fibular graft was performed on two or three stage according to the degree of infection. Initially free vascular pedicled graft was done followed by ipsilateral vascularized fibular graft. Type of free flap used is scapular free flap 3 cases, latissimus dorsi free flap 5 cases and dorsalis pedis flap 1 cases. The patients were followed for an average of 3.4 years. the average time to union was 6.7 months, and in all patients the graft healed in spite of complication. Complication was free flap venous thrombosis in 1 cases, persistent infection in 1 cases, delayed bony union at the distal end of fibular graft in 2 cases. The results showed that more faster bony union was seen in which cases firmly internally fixated and more faster hypertrophy of graft in which cases was permitted to ambulate on early weight bearing and more faster healing in which cases debrided more meticulously. Reconstruction of tibia defect with free flap followed by Ipsilateral fibular transposition is a useful and safe method to avoid the potential risk of infection for patients with tibial large bone defect and soft tissue defect associated with infection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.6
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• pp.417-421
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• 2020

Objectives: The purpose of this paper is to introduce an effective technique to easily obtain adequate amounts of keratinized gingiva and vestibular depth. Materials and Methods: Free gingiva (vertical height 10 mm) was harvested on the palatal mucosa and a partial thickness flap was elevated on the recipient site with same width as the free gingiva graft. After a conventional suture, a titanium mesh covered the graft and was fixed with miniscrews. Titanium mesh was removed 4.1±2.5 weeks after surgery. The amount of keratinized gingiva and vestibular depth was measured at the final follow-up. Results: Nine patients (males 4, females 5; 53.9±14.1 years) who underwent bone graft surgery before vestibuloplasty were included. No free gingival graft failure or complications were encountered in any of the patients. The relapse rate for vestibular depth (23.3%) was lower than that for keratinized gingiva (48.3%) after 34.4±14.4 months (P=0.010). Conclusion: Vestibuloplasty with a free gingival graft using titanium mesh could be achieved with an acceptable amount of keratinized gingiva and an appropriate vestibular depth around dental implant.

• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.27-36
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• 2000

February 1995 to September 1999, authors have experienced seven cases of infected nonunion of tibial fractures with associated soft tissue injury and skin defect, and have accomplished union in all cases by free vascularized fibular graft. All grafts healed with no radiographic evidence of bone necrosis or resorption and have been able to treat large bony defect and skin defect simultaneously. In this study, five cases of vascularized free fibular osteocutaneous flap transfer and two cases of free fibular graft are reported. All of seven cases were infected nonunion of tibia. The results were obtained as follows 1) The mean duration of the radiologic bone union was average 5.3months. 2) Grafted fibular has been hypertrophied, average 10.6 months. 3) In five cases of preservation of posterior cortex of tibia, bony union and hypertrophy of grafted bone were earlier than that two cases of complete segmental resection of tibia. 4) In two cases which only free vascularized fibular graft were performed because achievement of cutaneous flap was failed, authors found that soft tissue defect was filled with granulation tissue and split-thickness skin graft was possible over the granulation tissue after 3 weeks postoperatively.