• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권3호
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• pp.253-263
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• 1995

Microsurgical vascularized bone transfer has the disadvantages of limitation of available donor sites, loss of donor function, and the possibility of donor site defects or deformity. To overcome these shortage of current microsurgical tissue transfer, the method of creating the neovascularized free flap has been introduced. Potentially, this technique must be an innovation in providing the free vascularized bone grafts that are not limited by natural vascular anatomy. But, as could be imagined technique resulted in unavoidable donor bone defect and additional operation for harvesting the autologous bone. The purpose of this study was to evaluate the efficacy of demineralized allogeneic bone as a possible substitute for autologous bone in fabricating the neo-osseous flap. By histologic, microangiographic and radioisotope method, the viability and vascularity of neo-osseous flap, which has been fabricated using allogeneic bone or autologous bone, was assessed in rat model. After 6 weeks, demineralized allogeneic bone showed consistent bone formation and neovascularization. The clinical and microscopic findings of demineralized allogeneic bone group were inferior to those of autogenous bone with regard to bone regeneration. The amount of bone blood floow per dry weight of demineralized allogeneic bone group was significantly higher than that of autogenous bone, even higher that of control intact iliac bone. In conclusion, findings supported that allogeneic bone could be the potential substitute for autologous bone source in creating a prefabricated neo-osseous flap.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권4호
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• pp.365-378
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• 1995

Allogeneic bone grafting has recently been used in oral and maxillofacial regions to restore the cosmetic and functional problem. There are several types of allogeneic bone grafts ; bone powder, bone chips, bone blocks. Empirically, it is thought to be better to combine the allogeneic bone chips to any type of tissue adhesive not to displace during packing and condensing. But, there are no reports about using tissue adhesive in allogeneic bone grafting. This experimental study is designed to investigate the effect of the fibrin adhesive on bone healing process after demineralized allogeneic bone grafting in 60 rats. In control groups (30 rats), routine demineralized allogeneic bone grafting were done in 7 ${\times}$ 7mm calvarial bone defects which were drilled intentioally. And we used the fibrin adhesive for holding the bone particle in experimental groups (30 rats). Each experimental specimen was sacrified at 1, 2, 4, 6, 8 weeks postoperatively The results were as follows : 1. The degree of inflammatory cell infiltrations were more prominent in experimental than in control groups till 2 weeks. 2. Early fibroblast proliferation and new capillary proliferation were uncorporated around graft sites in the experimental groups later than in control groups at early stages. 3. Osteoblastic activity in control group was more prominent at 2 weeks. 4. Osteoblastic activity in experimental groups was more prominent than in control group till 4 weeks. 5. New bone formation was more in control group than experimental group till 3 weeks, but similar appearance after that time. As above results, initial bone healing within 2 weeks were more processed in without adhesive group than with adhesive group. But above 4 weeks; similar bone healing were observed.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권2호
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• pp.137-152
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• 1995

This study was designed to evaluate the bone formation capability of the bone substitute when compared with autogenic bone, freeze-dried demineralized allogeneic bone and bioglass into parietal bone of the rats. We made the parietal bone defects in $7{\times}7mm$ size on rats and has performed the bone graft in each experimental groups. Postoperatively 1, 2, 4, 6, 8, weeks, each specimen stained with H & E, Masson's trichrome methods. We evaluated the osteogensis capability in each groups. The result were as follow : 1. Inflammatory cell infiltration approached at 1 week and disappeared at 4 weeks in all experimental group, expecially severe in freeze-dried demineralized allogeneic bone group. 2. New capillry proliferation was increased in autogeneic bone graft group than any other groups and was increased till 2 weeks and decreased in freeze-dried demineralized allogeneic bone group and was few in bioglass group. 3. Osteoblastic activity increased in autogeneic bone and freeze-dried demineralized allogeneic bone groups till 4 weeks, and decreased in 6 weeks which no difference between these groups. But, few occurred in bioglass group till 6 weeks. 4. Initial osteoclastic activity was prominent in freeze-dried demineralized allogeneic bone group and few in autogeneic bone group. 5. New bone formation bega at 1 week in autograft and freeze-dried demineralized allogenic bone groups, but, mild new bone formation at 8 weeks in bioglass.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권3호
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• pp.265-277
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• 1991

In this study, the healing changes of the implanted bone and its surrounding tissues were examined on the histopathologic basis following implantation of the freeze - dried and radiation - sterilized allogeneic bone in Rectus abdominicus of the rat. This study was performed to see the tissue recations after implantation of the freeze - dried and radiation - sterilized allogeneic bone and whether osteogenesis or osteo - induction or osteo - conduction is happened. And the results were as follows : 1. The shape of the implanted allogeneic bone of the 1, 2 - week group specimen was similar to that of normal bone in light - microscopic finding and the atrophy of cellular organells was found in trans - mission electron - microscopic finding. 2. The implanted allogeneic bone was surrounded with the dense fibroconnective tissues, and infiltration of the chronic inflammatory cells gradually became increased. 3. Hyaline degeneration was observed in the surrounding tissue at the 3, 4, 6 - week group specimen. 4. Light - microscopically the resorption of implanted bone became prominent after 4 - week group and the necrosis of allogeneic bone implant became severe with loss of cell components in lacuna. 5. Electron - microscopically, the osteoclast - like cells ere fond after, 2 - week group. It is summarized that the osteo - conduction potential of the bone is remained just after implanting the freeze - dried and radiation - sterilized allogeneic bone on Rectus abdominicus of the rat, but gradually it disappeared with the gradual increse of chronic inflammatory reaction and osteoclastic activity. So it is suggested that the antigenicity of the freeze - dried and radiation - sterilized bone is remained and it has little osteo - conductive activity when it is implanted in the muscle.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권3호
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• pp.217-231
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• 1997

Autogenous bone grafting has a broad range of applications and implications, and also limitations, though it is the oldest and most important reconstructive techniques in the oral and maxillofacial surgical field.Further understanding of bone healing mechanisms, bone physiology and bone biology, transplantation immunology, and development of tissue banking procedures had enabled oral and maxillofacial surgeons to reconstruct even the most difficult bony defects successfully with the preserved allogeneic bone implant. Now autogenous bone and allogeneic bone implants present a wide variety of surgical options to surgeons, whether used separately or in combination. The surgeons are able to make judicious and fruitful choices, only with a through knowledge of the above-mentioned biologic principles and skillful techniques. The author evaluated 116 cases where allogeneic bones were transplanted for oral and maxillofacial reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권4호
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• pp.337-349
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• 1995

Periosteum in general is described as a specialized fibrous membrane of mesenchymal origin consisting of two basis layers : outer fibrous layer consists of irregularly arranged dense connective-tissue with fibroblasts, and inner osteogenic or cambial layer is composed of more loosely arranged fibers, greater vascularity and flatted spindle-shaped pre-osteoblasts. This periosteum may serve in controlling bone growth, especially mandibular growth has been emphasized. But, the periosteum enwrapping the facial skeleton have been studied for many years leaving a controversy in opinion regarding the function of these structures. We evaluated the bone formation activity of te periosteum in allogeneic bone grafts which bones are made of freeze-dried preparation preoperatively. We made the calvarial bone defects, 5 ${\times}$ 7mm sized, amd grafted with allogeneic bone in rats, which a half of specimens has dissected the overlying periosteum and a rest intacted. After bone grafting, we evaluated the capacity ofbone formation of periosteum, 1, 2, 4, 6, 8 weeks postoperatively. There are subtle differences of bone formation during early healing period after demineralized allogeneic bone grafting between control groups with periosteum and experimental groups without periosteum.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.164-174
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• 1996

In order to develop the allogeneic bone implants instead of autogenous bone grafts for maxillofacial reconstruction, undemineralized freeze-dried human bone was processed. The freeze-dried human bone was implanted into the cranial and mandibular defects of the rabbits. The implants were evaluated clinically, roentgenographically and histomophometrically. And immunohistochemical evaluation of the implants was performed on the rat. The results were as follows : 1. When compared with control defects of $0.8{\times}0.8\;cm$, the implants on the rabbit defects displayed complete osseous bridging clinically and roentgenographically. Histomophometrically a minimal inflammatory cell infiltrate was present but the defects healed well clinically. 2. When compared with control grafts, the freeze-dried implants on the rat muscle displayed decreased antigenicity by immunohistochemical evaluation, due to freeze-drying process. 3. Undemineralized freeze-dried human bone in this study can be preserved as a bank bone in this study and seems to be applicable for clinical allogeneic bone grafts.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권3호
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• pp.287-299
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• 1997

Procurement, cutting, cleansing, freezing, freeze-drying, and demineralization of the allogeneic bone must be made under the germ-free stable condition without bacterial and/or viral contamination. Even thought the bone is procured under the germ free condition, we must have confidence on disinfection of all the solutions that come in contact with tissue during the whole procedure. Lots of antibacterial agents have been introduced for chemical sterilization. Recently ethylene oxide gas sterilization or radiation sterilization is frequently selected as a secendary sterilization procedure. The biological and biochemical response of the graft material differs with the type and concentration of the sterilizing agents, and various toxic reactions have been reported due to the graft material itself and the substance released by the chemicals. The authors conducted the Millipore filter test to observe the toxic effect on L929 fibroblasts according to the effect on activity of succinate dehydrogenase, during the secondary sterilization of the demineralized allogeneic bone powder with irradiation or ethylene oxide gas. The result were as follows : 1. Around the copper disk, positive control group, 10mm diameter discoloration was observed. 2. As same as the negative control group, the disk showed no discoloration. 3. The demineralized allogeneic bone which was sterilized with ethylene oxide gas or irradiation showed no cytotoxicity. 4. From this results, it is suggested that treatment with ethylene oxide gas or irradiation should be effective to sterilize the deminineralized allogeneic bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.46-52
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• 2009

The maxillary posterior edentulous region presents unique and challenging conditions in implant dentistry. The height of the posterior maxilla is reduced greatly as a result of dual resorption from the crest of the ridge and pneumatization of the maxillary sinus after the loss of teeth. Materials previously used for sinus floor grafting include autogenous bone, allogeneic bone, xenogenic bone and alloplastic materials. Autogenous bone is the material of choice, but its use is limited by donor-site morbidity, complications, sparse availability, uncontrolled resorption and marked volume loss. One way to overcome this problem would be to use bone substitutes alone as a osteoconductive scaffold for bone regeneration from the residual bone or in combination with allogeneic bone, which also has osteoinductive properties. The purpose of this article is to describe a double layers technique of demineralized and mineralized bone graft materials instead of autogenous bone in sinus floor augmentation of deficient posterior maxillary alveolar process and to report our experience with this technique. Our results show that maxillary sinus augmentation using mineralized and demineralized bone materials, when installed simultaneously with the implant or not, is good results for bone healing.

• 종양간호연구
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• 제4권2호
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• pp.110-123
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• 2004

The purpose of this study was to develop a clinical pathway for the allogeneic bone marrow transplantation donor. For this study, a conceptual framework was developed through a review of the literature including six steps which are using in Jones Hopkins Hospital. USA. The researcher reviewed 129 medical re-cords of donor who had bone marrow donation between January 2002 to January 2004, to identify the overall service contents required by these patients and to make a preliminary clinical pathway. A content validity test was done for the preliminary clinical pathway, a professional group screened 51 medical re-cords and adopted with 3 hospitalization days as the clinical pathway framework. In the fifth step, clinical pathway test was also done to 7 donors from April 28th to July, 2004. After these processes the final clinical pathway was developed. The results of this study are as follows: 1. The vertical axis of the clinical pathway Includes the following 9 items: vital signs, nursing assessment, activity, diet, intervention, medication, test, consultation and patient teaching. The duration of the horizontal axis was 3days from admission to discharge 2. Analysis of the 129 medical records indicated that the average length of stay was 3 4 days. The medical performance according to the vertical axis in the preliminary clinical pathway consisted of 51 items After clinical validity test, it steel consisted of 51 items in the final form. 3. Clinical Validity test was done to 7 bone marrow donors. During these process, The first patient was deleted because he was out of the criteria the investigate set and 6 patients were used, finally The result of this study indicated all of 7 donors were discharged on expected day. 4. Clinical pathway enables to improve the quality of care, multidisciplinary team work It also helps nursing bone marrow donor, effective education to donor or medical member. The results of this study suggest that clinical pathway may be able to improve the quality of nursing care for bone marrow transplantation donors.