• 제목/요약/키워드: Autologous bone

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두개골 조기 유합증 수술 시 두개골막 피판의 역할 (The Role of Pericranial Flap in Surgery of Craniosynostosis)

  • 변준희;임영민;유결
    • Archives of Plastic Surgery
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    • 제32권2호
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    • pp.189-193
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    • 2005
  • Reconstruction of calvarial bone defects from congenital anomaly or from bone loss due to traumatic or neoplastic processes remains a significant problem in craniofacial surgery and neurosurgery. To facilitate bone regeneration, there have been many trials such as autologous bone graft or allograft, and the addition of demineralized bone matrix and matrix-derived growth factor. Guided bone regeneration is one of the methods to accelerate bone healing for calvarial bone defects especially in children. Pericranium is one of the most usable structure in bone regeneration. It protects the dura and sinus, and provides mechanical connection between bone fragments. It supplies blood to bone cortex and osteoprogenitor cells and enhances bone regeneration. For maximal effect of pericranium in bone regeneration, authors used pericranium as a flap for covering calvarial defects in surgeries of 11 craniosynostosis patients and achieved satisfactory results: The bone regeneration of original cranial defect in one year after operation was 74.6%(${\pm}8.5%$). This pericranial flap would be made more effectively by individual dissection after subgaleal dissection rather than subperiosteal dissection. In this article, we reviewed the role of pericranium and reported its usefulness as a flap in surgery of craniosynostosis to maximize bone regeneration.

상악동 점막 거상 술식에서 자가 정맥 혈액의 사용이 상악동 저 증강에 미치는 영향 (THE USE OF AUTOLOGOUS VENOUS BLOOD FOR MAXILLARY SINUS FLOOR AUGMENTATION IN CONJUNCTION WITH THE SINUS MEMBRANE ELEVATION : AN EXPERIMENTAL STUDY)

  • 김하랑;모동엽;이천의;유재하;최병호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권5호
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    • pp.346-352
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    • 2009
  • There have been reports of successful bone formation with sinus floor elevation by simply elevating the maxillary sinus membrane and filling the sinus cavity below the lifted sinus membrane with a blood clot. But, in a review of the current literature, we found no animal study that substantiated blood clot's ability in this respect. The aim of this study was to investigate the effect of the method of maxillary sinus floor augmentation using the patient's own venous blood in conjunction with a sinus membrane elevation procedure. An implant was placed bilaterally in the maxillary sinus of six adult mongrel dogs so that it protruded 8 mm into the maxillary sinus after sinus membrane elevation. On one side of the maxillary sinus, the resultant space between the membrane and the sinus floor was filled with autologous venous blood retrieved from the dog. On the opposite side, the maxillary sinus was left untreated as a control. The implants were left in place for six months. The mean height of the newly formed bone in the sinus was 3.7 mm on the side without venous blood and 3.5 mm on the side with venous blood (p>0.05). There was no difference between the two sides regarding new bone height in the sinus. Our results indicate that filling the space between the lifted sinus membrane and the sinus floor with venous blood has no effect on bone formation around implants placed in the maxillary sinus cavity.

Polyetheretherketone Cage with Demineralized Bone Matrix Can Replace Iliac Crest Autografts for Anterior Cervical Discectomy and Fusion in Subaxial Cervical Spine Injuries

  • Kim, Soo-Han;Lee, Jung-Kil;Jang, Jae-Won;Park, Hyun-Woong;Hur, Hyuk
    • Journal of Korean Neurosurgical Society
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    • 제60권2호
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    • pp.211-219
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    • 2017
  • Objective : This study aimed to compare the clinical and radiologic outcomes of patients with subaxial cervical injury who underwent anterior cervical discectomy and fusion (ACDF) with autologous iliac bone graft or polyetheretherketone (PEEK) cages using demineralized bone matrix (DBM). Methods : From January 2005 to December 2010, 70 patients who underwent one-level ACDF with plate fixation for post-traumatic subaxial cervical spinal injury in a single institution were retrospectively investigated. Autologous iliac crest grafts were used in 33 patients (Group I), whereas 37 patients underwent ACDF using a PEEK cage filled with DBM (Group II). Plain radiographs were used to assess bone fusion, interbody height (IBH), segmental angle (SA), overall cervical sagittal alignment (CSA, C2-7 angle), and development of adjacent segmental degeneration (ASD). Clinical outcome was assessed using a visual analog scale (VAS) for pain and Frankel grade. Results : The mean follow-up duration for patients in Group I and Group II was 28.9 and 25.4 months, respectively. All patients from both groups achieved solid fusion during the follow-up period. The IBH and SA of the fused segment and CSA in Group II were better maintained during the follow-up period. Nine patients in Group I and two patients in Group II developed radiologic ASD. There were no statistically significant differences in the VAS score and Frankel grade between the groups. Conclusion : This study showed that PEEK cage filled with DBM, and plate fixation is at least as safe and effective as ACDF using autograft, with good maintenance of cervical alignment. With advantages such as no donor site morbidity and no graft-related complications, PEEK cage filled with DBM, and plate fixation provide a promising surgical option for treating traumatic subaxial cervical spine injuries.

가토충양돌기세포(家兎蟲樣突起細胞)의 특이항원(特異抗原) 및 Mitogen에 대(對)한 반응(反應) (Response of Rabbit Appendix Cells to Specific Antigen and Mitogen)

  • 하대유
    • 대한미생물학회지
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    • 제10권1호
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    • pp.1-8
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    • 1975
  • Despite a number of recent studies on appendix its function appears to remain unknown. The present studies were undertaken in order to extend and confirm the previous studies concerning the role of appendix in immune response. An early hemagglutinin response of mercaptoethanol sensitive antibody(IgM antibody) in rabbit injected intravenously(i.v.) with 200mcg of bovine gamma globulin(BGG) was abolished by lethal whole body irradiation(900 r), but preserved in animals whose appendix and bone marrow were shielded during irradiation. Late formation of mercaptoethanol resistant antibody(IgG antibody) and the development of memory in bone marrow shielded animals were not affected by irradiation of the appendix. Formation of either IgM or IgG antibody to sheep red blood cells(SRBC) injected i.v. as determined by direct plaque forming cell(DPFC) technique in spleen were effectively abolished by appendectomy, thymectomy, or both followed by irradiation. When bone marrow was shielded in combination with autologous appendix reconstitution, DPFC response was about 5 times greater than the sum of two. Lysed appendix cells failed to restore the response. Lethally irradiated rabbits restored with combination of autologous appendix and thymus cells showed DPFC responses which were essentially normal. Three pools of appendix were obtained by manual separation technique and were stimulated with soluble concanavalin A(Con A), phytohemagglutinin-P(PHA) and pokeweed mitogen(PWM). Rabbit appendix cells responded to Con A, PHA and PWM. Cells of thymus dependent area(TDA) of the appendix were relatively enriched in their response to T cell mitogens compared to dome and follicle cells. The PHA/Con A responsive ratio of appenix TDA subpopulation was high, indicating that Con A responsive cells have a wider distribution among appendix. This finding showed that interfollicular area of the appendix is thymus-dependent. The present studies confirmed other evidence that the rabbit appendix cells itself are unable to form antibody and T lymphocytes in appendix TDA may be heterogenous, and that the appendix cells are synergistic with either bone marrow or thymus cells in the early hemagglutinin on splenic antibody response to BGG or SRBC.

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조직공학적 인조혈관의 생체 내 이식 실험 (In Vivo Experiment of Tissue-Engineered Artificial Vessel)

  • 임상현;조승우;홍유선;김병수;유경종;장병철;최차용
    • Journal of Chest Surgery
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    • 제37권3호
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    • pp.220-227
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    • 2004
  • 관상동맥 질환과 말초혈관 질환의 증가에 따라 직경 6 mm 이하의 소구경 혈관의 필요성이 증가하고 있다. 저자들은 조직공학적 방법을 이용하여 소구경 인공혈관을 제작하여 생체 실험을 시행하였다. 동종 판막을 얻어 이를 탈세포화시킨 후 피실험동물의 골수를 채취하여 탈세포화시킨 혈관용 지지체(scaffold) 위에 이식하였다. 이와 같이 하여 제작된 인공 혈관을 잡견의 양측 경동맥에 이식한 후 혈관이 막히거나, 8주가 되었을 때 이를 제거하여 조직학적 검사를 시행하였다. 자가 세포를 이식하지 않고 지지체만을 이식하였던 대조군 4마리 중 3마리의 혈관은 2주 이내에 모두 막힌 것을 확인하였고 나머지 한 마리의 혈관은 혈관류(aneurysm)가 발생하였다. 그러나 자가 세포를 이식한 실험군 4마리 중 2마리는 각각 4주와 6주까지 혈관의 개통성을 유지하였고, 나머지 2마리는 8주까지 혈관의 개통성을 유지하였다. 조직학적 검사 결과, 8주까지 개통성을 유지하였던 혈관은 정상의 혈관과 거의 유사한 조직학적 구조를 나타내었다. 자가 세포와 탈세포화된 지지체를 이용하여 제작한 인공혈관은 조직학적 검사 결과 정상과 유사한 구조로 재생이 가능함을 보여주었다.

Treatment of fibrous dysplasia of the zygomaticomaxillary complex with radical resection and three-dimensional reconstruction with autologous calvarial bone graft

  • Ahn, Sung Jae;Hong, Jong Won;Kim, Yong Oock;Lew, Dae Hyun;Lee, Won Jai
    • 대한두개안면성형외과학회지
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    • 제19권3호
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    • pp.200-204
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    • 2018
  • Fibrous dysplasia (FD) is a rare, benign bone disease with abnormal bone maturation and fibroblastic proliferation. Optimal treatment of zone 1 craniofacial FD is radical resection and reconstruction. To achieve of structural, aesthetic, and functional goals, we use three-dimensionally designed calvarial bone graft for reconstruction of zygomatic defect after radical resection of FD. The authors used a rapid-prototyping model for simulation surgery for radical resection and immediate reconstruction. Donor site was selected from parietal bone reflect shape, contour, and size of defect. Then radical resection of lesion and immediate reconstruction was performed as planned. Outcomes were assessed using clinical photographs and computed tomography scans. Successful reconstruction after radical resection was achieved by three-dimensional calvarial bone graft without complications. After a 12-month follow-up, sufficient bone thickness and symmetric soft tissue contour was well-maintained. By considering three-dimensional configuration of zygomaticomaxillary complex, the authors achieved satisfactory structural, aesthetic and functional outcomes without complications.

Alveolar ridge preservation of an extraction socket using autogenous tooth bone graft material for implant site development: prospective case series

  • Kim, Young-Kyun;Yun, Pil-Young;Um, In-Woong;Lee, Hyo-Jung;Yi, Yang-Jin;Bae, Ji-Hyun;Lee, Junho
    • The Journal of Advanced Prosthodontics
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    • 제6권6호
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    • pp.521-527
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    • 2014
  • This case series evaluated the clinical efficacy of autogenous tooth bone graft material (AutoBT) in alveolar ridge preservation of an extraction socket. Thirteen patients who received extraction socket graft using AutoBT followed by delayed implant placements from Nov. 2008 to Aug. 2010 were evaluated. A total of fifteen implants were placed. The primary and secondary stability of the placed implants were an average of 58 ISQ and 77.9 ISQ, respectively. The average amount of crestal bone loss around the implant was 0.05 mm during an average of 22.5 months (from 12 to 34 months) of functional loading. Newly formed tissues were evident from the 3-month specimen. Within the limitations of this case, autogenous tooth bone graft material can be a favorable bone substitute for extraction socket graft due to its good bone remodeling and osteoconductivity.

Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion

  • Goyal, Lata
    • Restorative Dentistry and Endodontics
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    • 제39권1호
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    • pp.51-55
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    • 2014
  • The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.