• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권1호
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• pp.60-64
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• 1999

Recently, for the reconstruction of bony defect and cosmetic improvement, many graft materials and implants have been widely used in the various surgical situations. The alloplastic materials have many advantages such as simplicity of operation, no additional need of surgery, and easy manipulation. The $Medpor^{TM}$(porous high-density polyethylene, Porex Co., USA) was initially studied in 1972 for surgical implant and introduced as an implant material for oral and maxillofacial region by Sauer and King in 1988. This material permits full ingrowth of bone into the implants, substantially increasing the implant's incorporation into the recipient site. It can be shaved during the surgery, which results in an improvement and prefabricated various size and shapes to fit into the surgical defect. The $Medpor^{TM}$ was used in 32 patients from 1995 to 1997 at the maxillofacial region. It was used for paranasal augmentation in 24 cases, for malar augmentation in 2 cases, for infraorbital augmentation in 2 cases, for mandibular angle augmentation in 2 cases, for mandibular body augmentation in 2 cases, for chin vertical augmentation in 1 case. It was mainly fixed with miniplate or screw. There were few complications except one infection and one exposure of the implant.

• Journal of Yeungnam Medical Science
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• 제28권2호
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• pp.116-123
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• 2011

The incidence of breast cancer, the second most prevalent cancer type in South Korea, has increased by 6.8% annually in the last six years. The higher number of breast cancer patients has led to an increase in the cases of skin-sparing mastectomies, thereby increasing the need for reconstructive procedures. The reconstruction options include alloplastic techniques such as implant or autologous reconstruction with numerous flaps. The abdominal area is the preferred donor site for the harvest of autologous tissue for breast reconstruction. Breast reconstruction using abdonimal tissue is commonly accomplished using the transverse rectus abdominis myocutaneous (TRAM) flap. The establishment of microvascular surgery led to the development of the free TRAM flap because of its increased vascularity and decreased rectus abdominis sacrifice. The muscle-sparing TRAM, DIEP, and SIEA flap techniques were later developed in an effort to decrease the abdominal-donar-site morbidity by decreasing the injury to the rectus abdominis muscle and fascia. This article summarizes the various abdominal flaps for breast reconstruction.

• Journal of Korean Dental Science
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• 제3권1호
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• pp.25-31
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• 2010

This study sought to evaluate the effect of the type of grafts used in sinus lifting. A review of literature through MEDLINE search covering the period 1980 ~ 2006 was performed. After screening, this study was narrowed down to 2,452 patients receiving sinus lift grafts wherein 7,151 implants were placed. In this study, the types of grafts used in sinus augmentation were autogenous bone, allogenic bone, corticocancellous block bone, and various alloplastic materials. The success rate varied from 69% to 100% depending on the graft material type. The highest success rate was reported for the autogenous bone, with high success rates recorded for the most part in most studies.

• Journal of Periodontal and Implant Science
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• 제29권1호
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• pp.193-207
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• 1999

The purpose of this study was to compare the clinical results of guided tissue regeneration(GTR) using a resorbable barrier manufactured from an copolymer of polylactic acid (PLA) and polylaetic-glycolic acid(PLGA) with those of nonresorbable ePTFE barrier. Thirty two patients(25 to 59 years old) with one radiographically evident intrabony lesion of probing depth ${\geq}$6mm participated in a 6-month controlled clinical trial. The subjects were randomly divided into three independent groups. The first group(n=8) received a ePTFE barrier. The second group (n=12) received a resorbable PLA/PLGA barrier. The third group (n=12) received a resorbable PLA/PLGA barrier combined with an alloplastic bone graft. Plaque index (PI), gingival index(GI), probing depth(PD), gingival recession, clinical attachment level(CAL), and tooth mobility were recorded prior to surgery and at 3, 6 months postsurgery, Statistical tests used to analyze these data included independent t-test, paired t-test, one-way ANOVA. The results were as follows : 1. Probing depth was significantly reduced in all groups at 3, 6 months postsurgery and there were not significant differences between groups. 2. Clinical attachment level was significantly increased in all groups at 3, 6 months postsurgery and there were not significant differences between groups. 3. There were not significant differences in probing depth, clinical attachment level, gingival recession, tooth mobility between second group (PLA/PLGA barrier) and third group (PLA/PLGA barrier combined with alloplastic bone graft) 4. Tooth mobility was not significantly increased in all groups at 3, 6 months postsurgery and there were not significant differences between groups. In conclusion, PLA/PLGA resorbable barrier has similar clinical potential to eP'IFE barrier in GTR procedure of intrabony pockets under the present protocol.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.276-292
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• 1996

The purpose of this study was to evaluate whether removal of gingival epithelium with pulsed Nd :YAG laser could inhibit the downgrowth of junctional epithelium after alloplastic material grafting in periodontal bone defect. The periodontal bone defects were created surgically on the palatal aspect of the upper right and left molar teeth in 30 rats and filled with resorbable calcium carbonate($Biocoral\;450^{(R)}$: Inoteb, France). The control sites(right molar area) was sutured. The test side (left molar area) received controlled deepithelization of the oral and sulcular epithelium with pulsed Nd:YAG laser($Sunrise\;Maste^{(R)}$: Sunrise Technologies, U.S.A.) under the mode of 1.75W, 15Hz, 116mJ/pulse and was sutured. The control and test sites were evaluated clinically and histologically, at 1, 3, 7, 14, and 28 days postoperation. Clinically, the gingiva showed normal color and shape at the 5th day in the control site and at the 10th day in the test sites. Histologically, the junctional epithelium was formed at the 7th day in the control sites and at the 14th day in the test sites, and the long JE attachment were observed at the 28th day in both sites. The attachment of connective tissue to root surface was observed initially at the 7th day in the control sites and at the 14th day in the test sites, and completed at the 28th day in both sites. In summary, these results showed that the removal of oral epithelium using pulsed Nd:YAG Laser could not prevent epithelial downgrowth after alloplastic material implantation in rat periodontal bone defect.

• Journal of Periodontal and Implant Science
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• 제49권3호
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• pp.171-184
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• 2019

Purpose: To evaluate the effects of intra-alveolar socket grafting, subepithelial connective tissue grafts, and individualized abutments on peri-implant hard and soft tissue outcomes following immediate implant placement. Methods: This randomized experimental study employed 5 mongrel dogs, with 4 sites per dog (total of 20 sites). The mesial roots of P3 and P4 were extracted in each hemimandible and immediate dental implants were placed. Each site was randomly assigned to 1 of 4 different treatment groups: standardized healing abutment (control group), alloplastic bone substitute material (BSS) + standardized healing abutment (SA group), BSS + individualized healing abutment (IA group), and BSS + individualized healing abutment + a subepithelial connective tissue graft (IAG group). Clinical, histological, and profilometric analyses were performed. The intergroup differences were calculated using the Bonferroni test, setting statistical significance at P<0.05. Results: Clinically, the control and SA groups demonstrated a coronal shift in the buccal height of the mucosa ($0.88{\pm}0.48mm$ and $0.37{\pm}1.1mm$, respectively). The IA and IAG groups exhibited an apical shift of the mucosa ($-0.7{\pm}1.15mm$ and $-1.1{\pm}0.96mm$, respectively). Histologically, the SA and control groups demonstrated marginal mucosa heights of $4.1{\pm}0.28mm$ and $4.0{\pm}0.53mm$ relative to the implant shoulder, respectively. The IA and IAG groups, in contrast, only showed a height of 2.6mm. In addition, the height of the mucosa in relation to the most coronal buccal bone crest or bone substitute particles was not significantly different among the groups. Volumetrically, the IA group ($-0.73{\pm}0.46mm$) lost less volume on the buccal side than the control ($-0.93{\pm}0.44mm$), SA ($-0.97{\pm}0.73mm$), and IAG ($-0.88{\pm}0.45mm$) groups. Conclusions: The control group demonstrated the most favorable change of height of the margo mucosae and the largest dimensions of the peri-implant soft tissues. However, the addition of a bone substitute material and an individualized healing abutment resulted in slightly better preservation of the peri-implant soft tissue contour.

• Journal of Periodontal and Implant Science
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• 제38권sup2호
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• pp.373-384
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• 2008

Purpose: The aim of this study is to compare the healing response of various Hydroxyapatite(HA) coated dental implants by Ion-Beam Assisted Deposition(IBAD) placed in the surgically created circumferential gap in dogs. Materials and methods: In four mongrel dogs, all mandibular premolars and the first molar were extracted. After an 8 weeks healing period, six submerged type implants were placed and the circumferential cylindrical 2mm coronal defects around the implants were made surgically with customized step drills. Groups were divided into six groups : anodized surface, anodized surface with 150nm HA and heat treatment, anodized surface with 300nm HA and heat treatment, anodized surface with 150nm HA and no heat treatment, and anodized surface with 150nm HA, heat treatment and bone graft, anodized surface with bone graft. The dogs were sacrificed following 12 weeks healing period. Specimens were analyzed histologically and histomorphometrically. Results: During the healing period, healing was uneventful and implants were well maintained. Anodized surface with HA coating and $430^{\circ}C$ heat treatment showed an improved regenerative characteristics. Most of the gaps were filled with newly regenerated bone. The implant surface was covered with bone layer as base for intensive bone formation and remodeling. In case that graft the alloplastic material to the gaps, most of the coronal gaps were filled with newly formed bone and remaining graft particles. The bone-implant contact and bone density parameters showed similar results with the histological findings. The bone graft group presented the best bone-implant contact value which had statistical significance. Conclusion: Within the scope of this study, nano-scale HA coated dental implants appeared to have significant effect on the development of new bone formation. And additional bone graft is an effective method in overcoming the gaps around the implants.

• Journal of Periodontal and Implant Science
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• 제24권1호
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• pp.120-130
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• 1994

The purpose of the present investigation was to compare the effectiveness of porous hydroxyapatite (PHA) and coralline based porous calcium carbonate(PCC) as implant materials in human periodontal osseous defects. 10 adult patients having periodontitis and 2 similar angular osseous defects ${\ge}$5mm as verified by radiographic analysis and clinical probing depth ${\ge}$4mm were selected. The measurements were recorded just before surgery and after 6 month. Clinical parameters used in this study included gingival recession, pocket depth, probing attachment level, Sulcus Bleeding Index, Plaque Index, tooth mobility and bone defect depth measurements. After initial therapy, patients were treated with mucoperiosteal flap surgery. The contralateral bony defects in each patient randomly assigned to either bone graft material, one with PHA(Interpore 200) and the other with coralline based calcium carbonate(Biocoral). After 6 month both groups showed statistically significant reduction of pocket depth, Sulcus Bleeding Index, Plaque Index and significant improvement in probing attachment level. No statistically significant differences were found between the groups. There were 3.0mm or 68% of bone repair with PHA and 3.1mm, 61% with PCC. These values were likewise not significantly different. The data and clinical impression strongly suggest that both PHA and PCC are alloplastic implants with clinically apparent acceptance by the soft and hard tissue and that they can be used as bone graft materials successfully.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.365-370
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• 2019

The syndrome of the trephined is a neurologic phenomenon that manifests as sudden decline in cognition, behavior, and sensorimotor function due to loss of intracranial domain. This scenario typically occurs in the setting of large craniectomy defects, resulting from trauma, infection, and/or oncologic extirpation. Cranioplasty has been shown to reverse these symptoms by normalizing cerebral hemodynamics and metabolism. However, successful reconstruction may be difficult in patients with complex and/or hostile calvarial defects. We present the case of a 48-year-old male with a large cranial bone defect, who failed autologous cranioplasty secondary to infection, and developed rapid neurologic deterioration leading to a near-vegetative state. Following debridement and antibiotic therapy, delayed cranioplasty was accomplished using a polyetheretherketone (PEEK) implant with free chimeric latissimus dorsi/serratus anterior myocutaneous flap transfer for vascularized resurfacing. Significant improvements in cognition and motor skill were noted in the early postoperative period. At 6-month follow-up, the patient had regained the ability to speak, ambulate and self-feed-correlating with evidence of cerebral/ventricular re-expansion on computed tomography. Based on our findings, we advocate delayed alloplastic implantation with total vascularized soft tissue coverage as a viable alternative for reconstructing extensive, hostile calvarial defects in patients with the syndrome of the trephined.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.527-532
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• 2000

A review of the literature, provided by a MEDLINE search from 1980 through June 1999, was performed. This study was screened that 649 patients received 679 sinus lift grafts in which 2056 implants were placed. The types of grafts in sinus augmentation were autogenous bone, corticocancellous block bone, allogenic bone, and a variety of alloplastic materials. Results of these grafts are presented. The most frequent complications was the infection of maxillary sinus. Long-term follow-up is necessary to advance the sinus elevation and to support posterior maxillary restorations.