• Archives of Plastic Surgery
• /
• v.43 no.1
• /
• pp.3-9
• /
• 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 the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.39 no.1
• /
• pp.27-30
• /
• 2013

Dental implantation in the mandibular anterior region is considered a safe and reliable surgical procedure. On the other hand, several articles have reported that inadvertent hemorrhage of the sublingual artery can result in life-threatening airway obstruction. Surgical ligation under intubation or tracheostomy is the most widely used approach for controlling mouth floor bleeding in this highly vascular region. Nonetheless, surgically exploring the bleeding focus is difficult because of anatomical distortion followed by widespread edema and swelling. Since swelling of the mouth floor advances quickly, timely management is essential for favorable postoperative outcome. This paper reports a case of immediate hemorrhage control with angiographic embolization to perform rapid hemostasis before the ongoing swelling causes airway obstruction. Less invasive, angiographic embolization can prevent neurovascular damage during a surgical exploration of injured vascular structures on the mouth floor.

• The Journal of Korean Academy of Prosthodontics
• /
• v.38 no.4
• /
• pp.552-560
• /
• 2000

Purpose : The purpose of this study was to determine proper position and angulation of an implant for immediate implantation. Materials and Method : From the years 1997 to 2000. 52 Denta $scan^R$ views, 22 upper and 32 lower jaw with an average age of 43 and 40 respectively, were investigated, which comprise intact upper and lower 6 anterior teeth and premolars. On the Denta $scan^R$, the optimal placement for the immediated implantation was simulated. The measuring methods included 1) Angulation difference between tooth long axis and alveolar bone process. 2) Angulation difference of long axis between tooth and installing fixture 3) Distance between center of tooth at cervical area and center of fixture. 4) Distance from root apex to the bone limit of vital structure. One sample t-test was used for statistical analysis. Result : The results were as follows. 1) At the maxillary central incisor and lateral incisor, angulation difference of long axis between tooth and installing fixture was respectively 0.5 and 3.2 degrees with the fixture center's palatally positioned 2mm apart from tooth center. 2) At the lower anterior 6 teeth, that was about $-2.8^{\circ}\;to\;-4.6^{\circ}$ with the fixture center's lingually positioned 1mm apart from tooth center. 3) At the maxillary canine and premolar, that was respectively $11.8^{\circ}\;and \;7.2^{\circ}$ with the fixture center palatally positioned $2\sim2.4mm$ apart from tooth center. 4) At the lower premolar area, that was about $0^{\circ}\;to\;2^{\circ}$ with the fixture center's lingually positioned $0.5{\sim}1mm$ apart from tooth center. 5) Distance from root apex to the bone limit of vital structure, at the maxillary anterior and premolars. was the range of 10 to 12mm, and at the mandibular anterior teeth and the 1st premolar, that was the range of 18 to 20mm. Conclusion : The proper implant position of maxillary anterior and premolar teeth is as paralleled as or more buccally angulated than long axis of tooth with the fixture center's palatally positioned. In mandiblular anterior region, long axis of implants is lingully angulated compared with long axis of tooth and in premolar, almost parelleled with long axis of tooth and alveolar process.

• Archives of Plastic Surgery
• /
• v.49 no.5
• /
• pp.652-655
• /
• 2022

Patients with advanced malignant tumors, including both jaws, is a challenging task for a head and neck surgeon. Current treatment landscape demonstrates good functional, anatomical, and aesthetic results in patients who could previously receive only palliative care. The extensive tissue defects resulting from oncological resections in the head and neck region require immediate reconstruction due to the exposure of vital structures and their contact with the external environment. A patient was operated using a three-team multidisciplinary approach involving simultaneous work of three specialized teams of maxillofacial and reconstructive microsurgeons, as well as an implantologist and a prosthodontist. This approach allowed simultaneous tumor resection with subsequent reconstruction of the intraoperative defect involving bilateral harvesting of two revascularized free fibular osteomusculocutaneous flaps with dental implantation and simultaneous rehabilitation of dentition with crowns.

• Journal of Chest Surgery
• /
• v.31 no.6
• /
• pp.629-633
• /
• 1998

Implantation of malignant cells along the needle aspiration tract is an extremely rare potential complication following a percutaneous fine needle aspiration biopsy of a lung carcinoma. The dissemination of malignant cells by a needle aspiration biopsy may convert an operable and potentially curable lesion into a fatal disease. We report two cases of chest wall implantation of carcinoma of the lung after a thin needle aspiration biopsy. A fifty-five year old male was successfully treated by a radical full-thickness excision of the chest wall and immediate reconstruction with the latissimus dorsi musculocutaneous island flap. A sixty-eight year old female was treated with a partial-thickness excision of the chest wall and skin graft due to superimposed infection and ulceration of the metastatic chest wall carcinoma. One case lived for 31 months up to November 1994, and the other's condtion has been uneventful for 3 months up to now.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.43 no.4
• /
• pp.276-281
• /
• 2017

This case series study demonstrates the possibility of successful implant rehabilitation without bone augmentation in the atrophic posterior maxilla with cystic lesion in the sinus. Sinus lift without bone graft using the lateral approach was performed. In one patient, the cyst was aspirated and simultaneous implantation under local anesthesia was performed, whereas the other cyst was removed under general anesthesia, and the sinus membrane was elevated in a second process, followed by implantation. In both cases, tapered 11.5-mm-long implants were utilized. With all of the implants, good stability and appropriate bone height were achieved. The mean bone level gain was 5.73 mm; adequate bone augmentation around the implants was shown, the sinus floor was moved apically, and the cyst was no longer radiologically detected. Completion of all of the treatments required an average of 12.5 months. The present study showed that sufficient bone formation and stable implantation in a maxilla of insufficient bone volume are possible through sinus lift without bone materials. The results serve to demonstrate, moreover, that surgical treatment of mucous retention cyst can facilitate rehabilitation. These techniques can reduce the risk of complications related to bone grafts, save money, and successfully treat antral cyst.

• The Journal of Korean Academy of Prosthodontics
• /
• v.47 no.4
• /
• pp.435-444
• /
• 2009

Statement of problem: The clinical use of electric and electomagnetic fields for fracture healing applications began in the early 1970s. Since then, several technologies have been developed and shown to promote healing of fractures. Developments of these devices have been aided in recent years by basic research and several well controlled clinical trials not only in the medical field but in dentistry. Purpose: The purpose of this study was to compare alveolar bone reduction following immediate implantation using implants onto which magnets were attached in fresh extracted sockets. Material and methods: Four mongrel dogs were involved. Full buccal and lingual mucoperiosteal flaps were elevated and third and fourth premolars of the mandible were removed. Implants with magnets and implants without magnets were installed in the fresh extracted sockets and after 3 months of healing the animals were sacrificed. The mandibles were dissected and each implant sites were sampled and processed for histological examination. Results: The marginal gaps that were present between the implant and walls of the sockets at the implantation stage disappeared in both groups as a result of bone fill and resorption of the bone crest. The buccal bone crests were located apical of its lingual counterparts. At the 12 week interval the mean of marginal bone resorption in the control group was significantly higher than that of the magnet group. The majority of specimens in magnet group presented early bone formation and less resorption of the buccal marginal bone compared to the control group. Conclusion: Within the limitations of this study, it could be concluded that implants with magnets attached in the early stages of implantation may provide more favorable conditions for early bone formation and reduce resorption and remodeling of marginal bone.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.16 no.4
• /
• pp.499-507
• /
• 1994

The aim of this experiment is to compare the healing process of extraction sockets after immediate implant placement with those using autogenous bone grafts and guided tissue regeneration with Gore-Tex. The first lower premolars and the second premolars of six experimental dogs were extracted and Stryker fin type implants were placed into the extraction sockets immediately after extraction. In the control group, any graft materials were'not used and the dead space around implants was left in itself and covered with only periosteum. In the experimental group A, implants were covered with Gore tex without any bone grafts, and in the experimental group B, the dead space around implants was filled with the bone chips gained from drilling procedure. Each experimental dogs were sacrificed at the 1st, 2nd, 3rd, 6th, and 8th week and the specimens were observed by gross examination, radiological examination, and light microscopic examination. The following results were obtained. 1. Well healed soft tissue and no mobility of the implants were observed in control and two experimental groups. 2. In the radiogical examination, radiopacity around implants had been increased gradually. 3. In the microscopic examination, there were good healing process and active new bone formation in both in the experimental groups, Especially the more amount of new bone formation occurred in the experimental group B using bone chips. 4. Bone chip grafts and guided tissue regeneration (GTR) using Gore-Tex may be one of the successful methods in the immediate implantation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.47 no.6
• /
• pp.411-426
• /
• 2021

Combining different procedures to reduce the number of surgical sessions and patient discomfort in implant placement and sinus floor elevation has been recommended, and evidence supports good outcomes. The aim of this study was to review the results of clinical studies on sinus floor elevation through extraction sockets and simultaneous immediate posterior implant placement. An electronic search was carried out in PubMed, Scopus, and Web of Science to find English articles published in or before August 2020. A manual search was also performed. Titles, abstracts, and the full-text of the retrieved articles were studied. Thirteen studies met our eligibility criteria: 6 retrospective case series, 3 case reports, 2 prospective cohort case-series, 1 prospective case series, and 1 randomized controlled trial. Overall, 306 implants were placed; 2 studies reported implant survival rates of 91.7% and 98.57%. The others either did not report the survival rate or reported 100% survival. Sinus floor elevation through a fresh extraction socket and simultaneous immediate implant placement appears to be a predictable modality with a high success rate. However, proper case selection and the expertise of the clinician play fundamental roles in the success of such complex procedures.

• The korean journal of orthodontics
• /
• v.33 no.2 s.97
• /
• pp.91-102
• /
• 2003

This study was performed to investigate the effect of immediate orthodontic force on soft md hard tissues surrounding C-Palatal $Plate^{TM}$ in beagle Dog. Immediately after this appliance was implanted on the midpalate of 4 adult beagle Dogs, 400gm continuous orthodontic force was applied. Experimental animals were euthanized at 8weeks, 18weeks, and 22weeks (including post-removal healing time of 4weeks), and a control animal was euthanized at 8weeks after implantation without orthodontic force application. The appliance and the surrounding tissue were studied radiographically, macroscopically, and histologically. The results were as follows: 1. The lateral radiographs taken after euthanasia showed very slight displacement of the vortical plate in the experimental animals, compared with the control animal. Mobility test of all animals confirmed primary stability without any increase of mobility during experimental period. 2. No pathologic changes were found in the healing condition of covering soft tissue and bone-screw interface in experimental animals as well as a control animal. 3. Osseointegration was achieved in the bone-screw interface in 8weeks after implantation and the amount of osseointegration increased in 18weeks. There was little difference of osseointegration between the compression side and the tension side. 4. In the marginal bone area, slight bone apposition and resorption were found regardless of compression and tension side, while there was no change in the control animal. 5. Both 8week-animal and 18week-animal showed the new bone apposition along the surface of screws which were perforated into the nasal cavity, while the control animal showed no change. 6. After 4weeks of plate removal, the covering epithelium was repaired intactly, while the connective tissue showed loose and irregular rearrangement and the connective tissue capsule remained. The C-Palatal $Plate^{TM}$ manifested sufficient anchorage capacity in the context of histological study as well as clinical outcomes, when immediate orthodontic force was applied after implantation.