• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.209-214
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• 1999

Chronic recurrent TMJ dislocation results in difficulty of mastication, speaking, and swallowing due to the limitation of the mandibular movement. Etiologic factors are considered as the looseness of the capsule and ligaments, the decrease of the articular eminence, condylar morphologic change, muscular disharmony near by TMJ, and the decrease of the vertical length of the mandibular ramus. Treatment approach has been suggested that surgical methods are selected for the correction of the etiologic factors when conservative treatments are not effective. Many surgical methods have been reported such as eminectomy, eminence augmentation, condylotomy, and zygomatic arch down fracture technique. We performed the eminence augmentation through interpositional bone graft in chronic recurrent TMJ dislocation. This method leads to favorable postoperative result without recurrence and complication, so we report the case with related references.

• Journal of Periodontal and Implant Science
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• v.53 no.3
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• pp.218-232
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• 2023

Purpose: This study evaluated the efficacy of a tube-shaped poly(ε) caprolactone - β tricalcium phosphate (PCL-TCP) scaffold with the incorporation of human umbilical cord-derived mesenchymal stem cells (hUCMSCs) and platelet-rich plasma (PRP) for bone regeneration in the procedure of single-stage sinus augmentation and dental implantation in minipigs. Methods: Implants were placed in the bilateral sides of the maxillary sinuses of 5 minipigs and allocated to a PCL-TCP+hUCMSCs+PRP group (n=5), a PCL-TCP+PRP group (n=5), and a PCL-TCP-only group (n=6). After 12 weeks, bone regeneration was evaluated with soft X-rays, micro-computed tomography, fluorescence microscopy, and histomorphometric analysis. Results: Four implants failed (2 each in the PCL-TCP+hUCMSCs+PRP and PCLTCP+hUCMSC groups). An analysis of the grayscale levels and bone-implant contact ratio showed significantly higher mean values in the PCL-TCP+hUCMSCs+PRP than in the PCL-TCP group (P=0.045 and P=0.016, respectively). In fluoromicroscopic images, new bone formation around the outer surfaces of the scaffolds was observed in the PCLTCP+hUCMSCs+PRP group, suggesting a tenting effect of the specially designed scaffolds. Bone regeneration at the scaffold-implant interfaces was observed in all 3 groups. Conclusions: Using a tube-shaped, honeycombed PCL-TCP scaffold with hUCMSCs and PRP may serve to enhance bone formation and dental implants' osseointegration in the procedure of simultaneous sinus lifting and dental implantation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.101-116
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• 1989

Proplast and Porous Polyethylene which have porous structures as low-modulus polymers have been recently used in maxillofacial plastic and reconstructive surgery. The purpose of this study was to compare the response of adajacent tissue, new bone formation and stability after augmentation by differen methods of subperiosteal graft using proplast and purous polythylene in rabbit mandible. The augmentation procedure was carried out by dividing into two groups, A and B. A group consisted of subperiosteal graft on the cortex, and the other B group was made up only graft following artificial decortication in the mandibular body of rabbit. The experimental animals were sacrificed on the 1st, 2nd, 4th and 8th week after grafting for macroscopic and light microscopic examination. The samples extracted at the 6th postgrafting week were also used for biometric testing and scanning electron microscopic examination. The results obtained from this study were as follows : 1. Macroscopically, infection of graft site, deformation and migration of graft material were not observed in all experimental groups. 2. B group showed more rapid and increased bone formation and the greater stability than A group, and tissue response was similar to each other. 3. In the tissue response, macrophages and cellular infiltrations were observed in Proplast group, but few in PHDPE group. 4. In bone formation of A group, Proplast group showed no bone formation until the 8th week, but PHDPE group showed small quantity of osteoid tissue from the 2nd week and appositional bone growth with new bone formation at the 8th week. 5. In bone formation of B group, both Proplast and PHDPE group showed bone formation, but PHDPE group showed more rapid and larger bone formation. 6. In pattern of bone formation, Proplast group mainly showed appositional bone growth pattern connected with graft site. On the other hand, PHDPE group showed mixed pattern of new bone formation in the pore connective tissue with appositional bone growth from graff site. 7. The maximum mean values of shear stress were serially $111.3gf/mm^{2}$ in PHDPE of B group, $84.8gf/mm^{2}$ in PHDPE of A group, $32.9gf/mm^{2}$ in Proplast B group, and $15.7gf/mm^{2}$ in Proplast of A group. From above results, It was suggested that the capacity of bone formation and stability between bone and graft material were dependent on the pore size and structure of graft material itself, the state of graft site and tissue response.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.1
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• pp.31-34
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• 2013

In dentistry, tissue expanders have been used to obtain sufficient soft tissue for alveolar bone augmentation in the severely atrophic ridge. Herein, we review two cases of soft tissue augmentation using a self-inflating tissue expander in patients in the Department of Oral and Maxillofacial Surgery at Ewha Womans University Mokdong Hospital for bone graft and implant operations. The results of each patient were presented using pre-operative and post-operative radiographs and clinical exams. The results of our study indicate successful bone graft and implant surgery using a self-inflating tissue expander.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.5
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• pp.428-433
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• 2004

Sinus floor augmentation has been proven an effective treatment procedure to increase bone volume in the posterior edentulous maxilla. Autogenous bone considered to be the best material for reconstructive bone surgery and has been successfully used as a graft material to augment posterior maxilla. However, the collection of autogenous bone required extra risks for morbidity and complaints. So, various bone graft materials included ${\beta}$-tricalcium phosphate(${\beta}$-TCP) has been introduced for replacing the autogenous bone. The objective of this clinical study was to determine the predictability of endosseous implant placed in a maxillary sinus with ${\beta}$-TCP grafting. We performed sinus elevation with ${\beta}$-TCP to install the implant in the 10 maxillary cases. The prosthetic procedure was performed 6-9 months after. The implant-prosthetics was checked about 1 year. We checked the implant and measured the maximum bite force to evaluate the function of the implant. There was not observed the specific problem and complication in dental implant and maxillary sinus in the grafted materials. The maximum bite force was 558N in case of natural tooth, 365N in implant without grafting, 318N in implant with ${\beta}$-TCP grafting. There was no significant difference between with and without sinus grafting on maximum bite force(p>0.05). As though the long term check-up is needed, the grafting of ${\beta}$-TCP as a osteoconductive materials can expand the volume and induce dense new bone formation in maxillary sinus. So, this short-term results support that ${\beta}$-TCP can be a suitable material for sinus augmentation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.1
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• pp.2-8
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• 2012

Introduction: Auto-tooth bone graft material consists of 55% inorganic hydroxyapatite (HA) and 45% organic substances. Inorganic HA possesses properties of bone in terms of the combining and dissociating of calcium and phosphate. The organic substances include bone morphogenetic protein and proteins which have osteoinduction capacity, as well as the type I collagen identical to that found in alveolar bone. Auto-tooth bone graft material is useful as it supports excellent bone regeneration capacity and minimizes the possibility of foreign body reaction,genetic diseases and disease transmission. Materials and Methods: Implant placement combined with osteoinductive regeneration,preservation of extraction socket, maxillary sinus augmentation, and ridge augmentation using block type,powder type, and block+powder type autobone graft materialwere performed for 250 patients with alveolar bone defect and who visited the Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University from September 2009 to August 2011. Results: Clinical assessment: Among the 250 patients of auto-tooth bone graft, clinical assessment was performed for 133 cases of implant placement. The average initial stabilization of placed implants was 74 implant stability quotient (ISQ). Radiological assessment: The average loss of crestal bone in the mandible as measured 6 months on the average after the application of prosthesis load was 0.29 mm, ranging from 0 mm to 3.0 mm. Histological assessment: In the histological assessment, formation of new bone, densified lamellated bone, trabecular bones, osteoblast, and planting fixtures were investigated. Conclusion: Based on these results, we concluded that auto-tooth bone graft material should be researched further as a good bone graft material with osteoconduction and osteoinduction capacities to replace autogenous bone, which has many limitations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.644-651
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• 2000

In cases of severe alveolar bony resorption in the edentulous posterior maxillae, implant placement is limited anatomically due to maxillary sinus. If the ridge is atrophic, the various bone grafting methods are required for the ridge augmentation. But the result of the onlay grafting procedure is not always promising. On the posterior maxilla, maxillary sinus mucosa lifting and bone grafting into the sinus floor, subantral augmentation(SA) technique are recommended. Various SA procedures have been developed for implant installation. We perfer to simultaneous block bone graft and implant installation through the residual alveolar ridge into the grafted block bone to fix the grafted bone and to gain the primary stability of the installed fixture. When a sagittal skeletal discrepancy in present due to the severe alveolar bony resorption of the maxilla, the advancement of the maxilla by Le Fort I osteotomy simultaneously with installation of implant fixtures combined with sinus lifting and interpositional bone graft procedure can be indicated. We applied various SA techniques for implant installtion to the 46 edentulous posterior maxillae, and total 154 implants were installed at our department from 1992 to 1999. Various SA techniques were classified in detail and the indications of each techniques were discussed. The changes of residual bony height following SA procedure were studied. The results were as follows. 1. The SA procedure combined with bone graft and simultaneous fixture installation were performed in 41 cases, 126 fixtures were installed and 5 fixtures were removed out of them. Le Fort I osteotomy procedure combined with sinus lifting and interpositional bone graft simultaneous with fixture installation were performed in 5 cases. Total 28 fixtures were installed and 2 fixtures were removed so far. 2. Autogenous block bone graft into sinus floor were performed in 35 cases, autogenous particulated marrow cancellous bone(PMCB) graft in 9 cases, and demineralized human bone powder in 2 cases. The donor site for bone graft were anterior iliac bone in 39 cases, posterior iliac bone in 3 cases and mandibular symphysis in 1 case and mandibular ramus in 1 case. 3. In 9 cases with which SA procedure had been performed with the block bone graft, the change of pre- and postoperative residual bony height were measured using MPR(multiplanar reformatted)-CT. The mean residual bony height was 8.0mm preoperatively, 20.2mm at 6 months following up operation and we gained average 12.2mm alveolar bony height. So, we can recommend this one-stage subantral augmentation and fixture installation technique as a time conserving, safe and useful method for compromised posterior edentulous maxilla.

• Journal of Periodontal and Implant Science
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• v.47 no.2
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• pp.77-85
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• 2017

Purpose: Guided bone regeneration (GBR) is the most widely used technique to regenerate and augment bones. Even though augmented bones (ABs) have been examined histologically in many studies, few studies have been conducted to examine the biological potential of these bones and the healing dynamics following their use. Moreover, whether the bone obtained from the GBR procedure possesses the same functions as the existing autogenous bone is uncertain. In particular, little attention has been paid to the regenerative ability of GBR bone. Therefore, the present study histologically evaluated the regenerative capacity of AB in the occlusive space of a rat guided bone augmentation (GBA) model. Methods: The calvaria of 30 rats were exposed, and plastic caps were placed on the right of the calvaria in 10 of the 30 rats. After a 12-week healing phase, critical-sized calvarial bone defects (diameter: 5.0 mm) were trephined into the dorsal parietal bone on the left of the calvaria. Bone particles were harvested from the AB or the cortical bone (CB) using a bone scraper and transplanted into the critical defects. Results: The newly generated bone at the defects' edge was evaluated using micro-computed tomography (micro-CT) and histological sections. In the micro-CT analysis, the radiopacity in both the augmented and the CB groups remained high throughout the observational period. In the histological analysis, the closure rate of the CB was significantly higher than in the AB group. The numbers of cells positive for runt-related transcription factor 2 (Runx2) and tartrate-resistant acid phosphatase (TRAP) in the AB group were larger than in the CB group. Conclusions: The regenerative capacity of AB in the occlusive space of the rat GBA model was confirmed. Within the limitations of this study, the regenerative ability of the AB particulate transplant was inferior to that of the CB particulate transplant.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.266-275
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• 2008

Dental endosseous implants require sufficient alveolar bone volume and quality for complete bone coverage and initial stability. But, atrophy or resorption of alveolar bone height and width according to patient's age and period of tooth loss can prevent ideal implant placement. Bone graft procedure has been proposed before or simultaneously with the placement of dental implants in patients with insufficient alveolar bone volume. While allografts, xenografts, and alloplastic bone grafts have been proposed and studied for alveolar ridge augmentation, the use of autogenous bone grafts represents the 'gold standard' for bone augmentation procedures. Conventional bone grafts are usually harvested from distant sites such as the ilium or ribs. Recently there is a growing use of intraoral bone grafts from intraoral donor sites such as mandibular symphysis, mandibular ramus and maxillary tuberosity. We recommend that the mandibular ramus is a safe autogenous bone graft donor site for bone harvesting with low morbidity. We report various effective autogenous bone graft procedures from mandibular ramus for the implant placement on various atrophic alveolar ridges.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.3
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• pp.254-261
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• 2009

The maxillary sinus bone graft procedure is one of the predictable and successful treatments for the rehabilitation of atrophic and pneumatized edentulous posterior maxilla. Materials used for maxillary sinus floor augmentation include autogenous bone, allogenic bone, xenogenic bone and alloplastic materials. Among them, autogenous bone grafts still represents 'gold standard'for bone augmentation procedures. We selected the mandibular ramus area as a donor site for the autogenous bone graft because of low donor site morbidity. We performed maxillary sinus bone graft procedures with implant placement using particulated ramal autobone and bovine bone mixture, and got good results. This is a preliminary report of the maxillary sinus bone graft using particulated ramal autobone and bovine bone, requires more long-term follow up and further studies.