• Title/Summary/Keyword: guide tissue regeneration

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A simple technique for repositioning of the mandible by a surgical guide prepared using a three-dimensional model after segmental mandibulectomy

  • Funayama, Akinori;Kojima, Taku;Yoshizawa, Michiko;Mikami, Toshihiko;Kanemaru, Shohei;Niimi, Kanae;Oda, Yohei;Kato, Yusuke;Kobayashi, Tadaharu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.16.1-16.6
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    • 2017
  • Background: Mandibular reconstruction is performed after segmental mandibulectomy, and precise repositioning of the condylar head in the temporomandibular fossa is essential for maintaining preoperative occlusion. Methods: In cases without involvement of soft tissue around the mandibular bone, the autopolymer resin in a soft state is pressed against the lower border of the mandible and buccal and lingual sides of the 3D model on the excised side. After hardening, it is shaved with a carbide bar to make the proximal and distal parts parallel to the resected surface in order to determine the direction of mandibular resection. On the other hand, in cases that require resection of soft tissue around the mandible such as cases of a malignant tumor, right and left mandibular rami of the 3D model are connected with the autopolymer resin to keep the preoperative position between proximal and distal segments before surgical simulation. The device is made to fit the lower border of the anterior mandible and the posterior border of the mandibular ramus. The device has a U-shaped handle so that adaptation of the device will not interfere with the soft tissue to be removed and has holes to be fixed on the mandible with screws. Results: We successfully performed the planned accurate segmental mandibulectomy and the precise repositioning of the condylar head by the device. Conclusions: The present technique and device that we developed proved to be simple and useful for restoring the preoperative condylar head positioning in the temporomandibular fossa and the precise resection of the mandible.

Peripheral Nerve Regeneration by Asymmetrically Porous PLGA/Pluronic F127 Nerve Guide Conduit

  • Oh, Se-Heang;Kim, Jun-Ho;Song, Kyu-Sang;Jeon, Byeong-Hwa;Lee, Il-Woo;Lee, Jin-Ho
    • Proceedings of the Polymer Society of Korea Conference
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    • 2006.10a
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    • pp.181-181
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    • 2006
  • We developed a novel method to fabricate a nerve guide conduit (NGC) with the porosity of submicron pore sizes (to prevent fibrous tissue infiltration) and hydrophilicity (for effective oxygen and nutrient permeation) using poly(lactic-co-glycolic acid) (PLGA) and Pluronic F127 by a modified immersion precipitation method designed by our laboratory. It was recognized that the hydrophilized PLGA/F127 (3 wt%) tube can be a good candidate as a NGC from the analyses of its morphology, mechanical strength, hydrophilicity, model nutrient permeability and in vivo nerve regeneration behavior using a rat model.

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Peripheral Nerve Regeneration Through Nerve Conduit Composed of Alginate-Collagen-Chitosan

  • Kim, Sang-Wan;Bae, Hong-Ki;Nam, Hye-Sung;Chung, Dong-June;Choung, Pill-Hoon
    • Macromolecular Research
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    • v.14 no.1
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    • pp.94-100
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    • 2006
  • Although the peripheral nerve system has a relatively good regenerating capacity compared to the central nerve system, peripheral nerve repair remains a clinical challenge as restoration of normal nerve function is highly variable. Synthetic tubular nerve conduits were designed as an alternative repair method in order to replace the need for an isograft. These nerve conduits guide regenerating axons from the proximal toward the distal end, maintain within growth-promoting molecules released by the nerve stumps, and protect regenerating axons from infiltrating scar tissue. In this work, we prepared cinnamoylated alginate (CA)-collagen-chitosan nerve conduit using the lyophilization method to generate a controllable parallel channel in the center and then investigated its influence on peripheral nerve regeneration in an animal study. At 12 weeks after implantation, histological study showed that tissue cable was continuously bridging the gap of the sciatic nerve in all rats. Our newly developed nerve conduit is a promising tool for use in peripheral nerve regeneration and provides a suitable experimental model for future clinical application.

Effect of Enamel Matrix Derivative on Guided Bone Regeneration with Intramarrow Penetration (골수내천공을 동반한 골유도재생술시 법랑기질유도체의 효과)

  • Lee, Young-Jong;Park, Joon-Bong;Kwon, Young-Hyuk;Herr, Yeek;Cho, Kyoo-Sung
    • Journal of Periodontal and Implant Science
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    • v.34 no.2
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    • pp.393-410
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    • 2004
  • The purpose of this study was to investigate effect of enamel matrix derivative on guided bone regeneration with intramarrow penetration in rabbits. Eight adult male rabbits (mean BW 2Kg) were used in this study. Intramarrow penetration defects were surgically created with round carbide bur(HP long #6) on calvaria of rabbits. Defects were assigned to the control group grafted with mixture of the same quantity of demineralized freeze-dried bone allograft and deproteinized bovine bone mineral. Then, guided bone regeneration was carried out using resorbable membrane and suture. Enamel matrix derivative applied to defects was assigned to the test group. And treated as same manners as the control group. At 1, 2, 3 and 8 weeks after the surgery, animals were sacrificed, specimens were obtained and stained with Hematoxylin-Eosin for light microscopic evaluation. The results of this study were as follows : 1. At 1, 2 and 3 weeks, no differences were observed between the control group and the test group in the aspect of bone formation around bone graft. 2. Proliferation of blood capillary was faster in the test group than in the control group. 3. Bone regeneration in intramarrow penetration was faster in the test group than in the control group. 4. At 8 weeks, new osteoid tissue formation around bone graft was more prominent in the test group than in the control group. From the above results, enamel matrix derivative might be considered as the osteopromotion material and effective in the guided bone regeneration with intramarrow penetration.

Clinical Study on Therapeutic Effects of Biodegradable membrane $Biomesh^{(R)}$ and autogenous bone grafts in infrabony defects (골내치주낭에 $Biomesh^{(R)}$ 차단막과 자가골이식의 치료효과에 대한 연구)

  • Suh, Jong-Jin;Chung, Ye-Jin;Choi, Byeong-Gap;Choi, Seong-Ho;Cho, Kyoo-Sung
    • Journal of Periodontal and Implant Science
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    • v.30 no.4
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    • pp.779-793
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    • 2000
  • The ultimate goal of periodontal disease therapy is to promote the regeneration of lost periodontal tissue, there has been many attempts to develop a method to achieve this goal, but none of them was completely successful. This study was designed to compare the effects of treatment using resorbable barrier membrane($Biomesh^{?}$) in combination with autogenous bone graft material with control treated by only modified Widman flap. 22 infrabony defecs from 10 patients with chronic periodontitis were used for this study, 10 sites of them were treated with resorbable barrier membrane and autogenous bone graft material as experimental group and 12 site were treated by only modified Widman flap as control group. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded at 6-8 months later, and the significance of the changes was statistically analyzed. The results are as follows : 1. Probing depth of the two group was reduced with statistically significance(P<0.05), but this changes were not different between the two experiment, control group with statistically significance. 2. Gingival recession showed statistically significant increase in control group(P<0.05), but not in experimental group, and initial values of the two group were in statistically significant difference(P<0.05). 3. Bone probing depth showed statistically significant decrease in experimental group(P<0.05), but not in control group, and this changes were different between the two experiment, control group with statistically significance(P<0.05). 4. Loss of attachment showed statistically significant decrease in experimental group(P<0.05), but not in control group, and this changes were different between the two experiment, control group with statistically significance(P<0.05) On the basis of these results, treatment using resorbable barrier membrane in combination with autogenous bone graft material improve the probing depth, bone probing depth and loss of attachment in infrabony defects.

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Clinical Effect of Guide Bone Regeneration of Mandibular Nonunion in a Geriatric Dog (노령견의 하악골절 불유합 1례에서 골유도재생술의 임상적 효과)

  • Kim, Se-Eun;Shim, Kyung-Mi;Bae, Chun-Sik;Choi, Seok-Hwa;Jeong, Soon-Jeong;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.127-130
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    • 2013
  • A 13-year-old, 4.2 kg female poodle was referred for failure of first bilateral mandibular surgery at a local animal hospital after pathologic fracture. Surgery was performed with 2.0-mm miniplates/screws and porcine cancellous bone grafts. In addition, because of the large size of the right segmental defect, a barrier absorbable membrane was employed for guide bone regeneration on right mandible. After surgery, follow-ups performed at 1 day, 1, 4, 8, and 12 weeks; there were no signs of dental malocclusion, nonunion or soft tissue infection. However, a 1-year long-term follow-up showed nonunion in the left mandibular fracture site for which a collagen membrane had not been used. It is considered that use of porcine bone graft with barrier absorbable membrane may be effective for the repair of mandibular nonunion in a geriatric dog.

Absorbable Guided Bone Regeneration Membrane Fabricated from Dehydrothermal Treated Porcine Collagen (Dehydrothermal Treatment로 제작한 흡수성 콜라겐 골유도재생술 차단막)

  • Pang, Kang-Mi;Choung, Han-Wool;Kim, Sung-Po;Yang, Eun-Kyung;Kim, Ki-Ho;Kim, Soung-Min;Kim, Myung-Jin;Jahng, Jeong-Won;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.112-119
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    • 2011
  • Purpose: Collagen membranes are used extensively as bioabsorbable barriers in guided bone regeneration. However, collagen has different effects on tissue restoration depending on the type, structure, degree of cross-linking and chemical treatment. The purpose of this study was to evaluate the inflammatory reaction, bone formation, and degradation of dehydrothermal treated porcine type I atelocollagen (CollaGuide$^{(R)}$) compared to of the non-crosslinked porcine type I, III collagen (BioGide$^{(R)}$) and the glutaldehyde cross-linked bovine type I collagen (BioMend$^{(R)}$) in surgically created bone defects in rat mandible. Methods: Bone defect model was based upon 3 mm sized full-thickness transcortical bone defects in the mandibular ramus of Sprague-Dawley rats. The defects were covered bucolingually with CollaGuide$^{(R)}$, BioMend$^{(R)}$, or BioGide$^{(R)}$ (n=12). For control, the defects were not covered by any membrane. Lymphocyte, multinucleated giant cell infiltration, bone formation over the defect area and membrane absorption were evaluated at 4 weeks postimplantation. For comparison of the membrane effect over the bone augmentation, rats received a bone graft plus different covering of membrane. A $3{\times}4$ mm sized block graft was harvested from the mandibular angle and was laid and stabilized with a microscrew on the naturally existing curvature of mandibular inferior border. After 10 weeks postimplantation, same histologic analysis were done. Results: In the defect model at 4 weeks post-implantation, the amount of new bone formed in defects was similar for all types of membrane. Bio-Gide$^{(R)}$ membranes induced significantly greater inflammatory response and membrane resorption than other two membranes; characterized by lymphocytes and multinucleated giant cells. At 10 weeks postoperatively, all membranes were completely resorbed. Conclusion: Dehydrotheramal treated cross-linked collagen was safe and effective in guiding bone regeneration in alveolar ridge defects and bone augmentation in rats, similar to BioGide$^{(R)}$ and BioMend$^{(R)}$, thus, could be clinically useful.

Aesthetic implant restoration with alveolar bone graft and digital method on maxillary central incisor: a case report (치조골이식과 디지털 방법을 활용한 상악 중절치 임플란트 심미 수복 증례)

  • Jang, Han-Sol;Pyo, Se-Wook;Kim, Sunjai;Chang, Jae-Seung
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.168-174
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    • 2022
  • In case of gingival recession or bone defect in maxillary anterior implant treatment, it is not easy to obtain satisfactory clinical results. In this case, loss of the labial alveolar plate was diagnosed in the maxillary right central incisor, so after tooth extraction, soft tissue was secured and implant placement with bone graft was planned. In addition, digital guide surgery was performed for the ideal implant position, and GBR (Guided Bone Regeneration) was accompanied with the xenogeneic bone and the autologous bone collected from the mandibular ramus since alveolar bone defects were extensive. After a sufficient period of osseointegration of the implant, a temporary prosthesis was fabricated through secondary stage surgery and impression taking, and through periodic external adjustment, the shape of soft tissue was improved. In the final prosthesis fabrication, a color tone of natural teeth was induced by an gold anodized customized abutment, and an aesthetic and functional zirconia prosthesis with reproducing the shape of the temporary prosthesis through intraoral scan was delivered.

Alveolar Ridge Augmentation Using Titanium Reinforced Goretex (TRG) and Titanium Mesh in Severe Alveolar Bone Loss Area: Case Report (심하게 흡수된 치조제에 Titanium 강화 Gore-Tex (TRG) 및 Titanium Mesh로 수직적 골증대술을 실시한 증례보고)

  • Kim, Won-Jik;Yoon, Kyung-Sun;Hong, Su-Ryun;Choi, Jin-Kyung;Lee, Yong-Uk;Kim, Dong-Suk;Hyun, Jong-Oh;Cho, Hyo-Won;Choi, Ji-Hye;Jung, Tae-Woong;Bae, Yoon-Ki;Kwon, Sun-Kyu;Choi, Hyun-Joon;Lee, Hyun-Su;Yang, Su-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.66-72
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    • 2011
  • A severely vertical resorbed ridge is a significant challenge in implant dentistry. To solve this problem, several augmentation techniques, such as guided bone regeneration (GBR), onlay bone grafts, distraction osteogenesis, and ridge splitting techniques, have been proposed and used for several years. Among these methods, vertical ridge augmentation using guided bone regeneration aims to build space and guide osteoblasts to this space to promote osteogenesis. The aim of guided bone regeneration is to maintain and stabilize the space and block the proliferation of adjacent soft tissue. In our hospital, we encountered a case of a woman in her forties with an atrophied mandible, who underwent implant surgery in the right mandible. Titanium reinforced Gore-Tex (TRG) was used to augment the mandible and titanium mesh was used in the left mandible. Favorable results were obtained. This report compares the two methods and reviews the relevant literature.