• Title/Summary/Keyword: Bone exposure

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Analysis of Repeated Bone Graft after Secondary Bone Graft in Children with Alveolar Cleft (치조열에서 재 시행한 골이식의 분석)

  • Koh, Kyung Suck;Lee, Sung Wook;Choi, Jong Woo;Lee, Young Kyoo;Kwoun, Soon Man
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.273-278
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    • 2008
  • Purpose: The most widely accepted protocol for alveolar cleft reconstruction is to repair it during the mixed dentition stage. There were lower resorption rate (about 88%) at this stage. However we found some cases that need repeated bone grafting. Therefore we sought to analyze the cause of repeated alveolar bone grafting in connection with other factors. Methods: From January 2000 to January 2006, thirty-nine secondary alveolar bone grafts with iliac crest spongiosa were carried out. In 39 patients, 5 patients who had significant bone graft resorption received repeated alveolar bone graft. In all the cases, the causes of repeated bone grafts were dental root exposure(angulation), and the deficiency of the bony support for lateral incisor or canine eruption. In 3 cases, there was deficiency of the alveolar bone at the cleft side. There was the need of repeated bone grafts for orthodontic treatment in 2 cases and for application of dental implants in 1 case. Results: During the follow-up period, the clinical and radiologic examinations showed that repeated alveolar bone grafts were maintained successfully without any complications. The volume of the repeated bone graft was sufficient for orthodontic treatment and implantation. Conclusion: The essential conditions for successful alveolar bone grafting includes the status of cleft sided teeth, further treatment and planed schedule, as well as canine eruption. Alveolar bone grafting has to be performed with difference of each case in mind.

All-Inside Technique of Anterior Cruciate Ligament Reconstruction using Central Quadriceps Tendon and Patella Bone Block (관절강 내에서 모든 수술 과정을 시행하는 관절경적 전방십자인대 재건술)

  • Jeong, Hwa-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.66-71
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    • 1997
  • The all inside anterior cruciate ligament reconstruction technique places an anterior ligament substitutes within two bony sockets rather than hone tunnel. This approach is accomplished through arthroscopic three portal which avoids the surgical exposure and morbidity associated with creating traditional bone tunnel. This technique has several distinct advantages when compared with the traditional ACL reconstruction through the bone tunnels. It offers the surgeon a less morbid method for ACL reconstruction that positions an ACL substitute at the anatomic attachment sites of the original ACL with two bone sockets, obviating the need for traditional bone tunnels. Graft fixation at or near the anatomic attachment points of the original ACL minimizes creep with early range of motion and reduces the abrasive 'wind-shield wipe' motion of the graft which occur with bone plugs positioned inside bone tunnels. The sagittal posterior angle to the tibial socket increases fixation strength to pullout with anterior translation force for the tibia on the femur. This technique is not graft specific and can accomodate any graft in which graft length can be customized to the intraarticular native ACL length.

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Treatment of Peri-implantitis: Cases Report (임플란트 주위염의 치료: 증례보고)

  • Sung, Hun-Mo;Kim, Kyoung-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.2
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    • pp.112-123
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    • 2013
  • This study aims to investigate the clinical outcome following treatment of peri-implantitis lesions. Five subjects with 7 implants were treated with surgical approach. Four subjects with 6 implants were initially treated with non-surgical approach or hygiene control. However, inflammation was not resolved and more bone loss was found. Therefore, surgical treatment was performed. After surgical exposure of the defect, granulation tissue was removed and implant surface was treated using tetracycline and chlorhexidine. Then, the flaps were sutured. The wound healing was performed in a non-submerged mode. The present finding demonstrates stable results without progression of bone loss. In one subject, deep V shaped bone defect was filled with bone substitute (ICB, CanCellous Bone, Rockey Mountain Tissue Bank, USA), and resorbable membrane (Lyoplant$^{(R)}$, B.Braun Aesculap AG, Germany) was placed over the grafted defect and healing abutment was connected. However, the inflammation was not resolved and more bone loss was found. At one month after regenerative surgery, the implant was removed.

Gracilis Muscle Free Flap Transplantation Followed Up Over 10 Years (10년 이상 추시된 박 근 유리 판 이식술)

  • Yu, Chang Eun;Park, Ki Tae;Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • v.20 no.2
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    • pp.108-112
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    • 2011
  • Purpose: Gracilis muscle free flap transplantation is chosen in the medium sized soft tissue defect and bone exposure from trauma and chronic osteomyelitis in the lower extremity. We set a study to search for gracilis free flaps to know whether symptoms were cured or recurred in patients that have passed over 10 years from flap transplantation. Materials and Methods: From August 1995 through September 2010, we have performed 28 cases of gracilis muscle free flap in the lower extremities. Ever since no case visited to demand any discomfort, breakdown or recurrence in the flap site on outpatient basis. We made a telephone call to patients or relatives documented in the medical record and only 2 cases visited outpatient department and 9 cases postponed the visit who satisfied with the final result but 17 cases had wrong telephone numbers. Causes, area of lower extremity, recipient vessels in the lower extremity, condition of the donor thigh and overall satisfaction of the flap transplantation in activities of daily living were investigated and written down in the medical record. Results: 11 cases were reviewed after average postoperative 13.7 years. Gracilis muscle flaps were not break down at the recipient site in all cases. The wound of donor thigh wound healed good and overall activities of daily living was satisfied in all cases. Conclusion: Gracilis muscle flaps which had performed and followed up average 13.7 years revealed confident in the medium sized soft tissue defect and bone exposure from trauma and chronic osteomyelitis in the lower extremity.

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A Pilot Study on Hip Bone Mineral Densities Estimation from Forearm CBCT images

  • Ko, Hoon;Lee, Chang-Hoon;Jeong, Kwanmoon;Lee, Myeung Su;Nam, Yunyoung;Yoon, Kwon-Ha;Lee, Jinseok
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.11 no.12
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    • pp.6054-6068
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    • 2017
  • In this paper, we defined the relative cross-sectional area of forearm cortical bone and investigated its correlation with hip bone mineral density values of total femur, femoral neck, femoral trochanter, femoral inter-trochanter and femoral ward's triangle, respectively. Based on the correlations, we established a linear transformation between the relative cross-sectional area of forearm cortical bone and each hip bone BMD. We obtained forearm images using CBCT and hip bone BMDs using dual-energy X-ray absorptiometry (DXA) for 28 subjects. We also investigated the optimal forearm region to provide the strongest correlation coefficient. We used the optimized forearm region to establish each linear transformation to estimate BMD values for total femur, femoral neck, femoral trochanter, femoral inter-trochanter and femoral ward's triangle from the relative cross-sectional area of forearm cortical bone, respectively. We observed the strong correlations with total femur (r=0.889), femoral neck (r=0.924), femoral trochanter (r=0.821), femoral inter-trochanter (r=0.867) and femoral ward's triangle (r=0.895), respectively. The strongest correlation was observed in the forearm mid-shaft regions. Our results suggest that the hip bone BMD values can be simply estimated from forearm CBCT images in a convenient sitting position without X-ray exposure on a hip including genital organs, and may be useful for screening osteoporosis.

The effect of peri-implant bone exposure on soft tissue healing and bone loss in two adjacent implants

  • Shin, Seung-Yun;Kye, Seung-Boem;Hong, Jong-Rak;Paeng, Jun-Young;Yang, Seung-Min
    • Journal of Periodontal and Implant Science
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    • v.42 no.1
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    • pp.20-24
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    • 2012
  • Purpose: The purpose of this study was to evaluate the soft tissue and bone change around two adjacent implants in onestage implant surgery. Methods: Eleven subjects (7 males, 4 females) who were needed placement of 2 adjacent implants in the molar area were included. The two implants were placed with the platform at the level of the alveolar crest. The interproximal bone between the 2 implants was not covered with gingiva. After surgery, an alginate impression was taken to record the gingival shape and radiographs were taken to evaluate implant placement. Using a master cast, the gingival height was measured at baseline, 4 weeks, and 12 weeks. In the radiograph, the alveolar bone level was measured at the mesial and distal side of both implants at baseline and 12 weeks. Results: The exposed bone was covered with gingiva at both 4 and 12 weeks. Loss of alveolar bone around implants was found in all areas. The alveolar bone level in the exposed bone area did not differ from that in the non-exposed area. Conclusions: This study showed that the alveolar bone level and gingival height around 2 adjacent implants in the exposed bone area did not differ from that in unexposed bone area.

Inhibitory effect of Ulmus davidiana Planch extracts on bone resorption mediated by processing of cathepsin K in cultured mouse osteoclasts

  • Park, Jun-Sung;Kim, Kyung-Ho;Jo, Hyun-Seog;Kim, Kap-Sung;Hwang, Min-Seob
    • Journal of Acupuncture Research
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    • v.22 no.2
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    • pp.55-70
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    • 2005
  • Objective: Ulmus davidiana Planch (Ulmaceae) has long been known to have anti-inflammnatory in the traditional Korean medicine. UD has been reported as a good enhancer for bone healing. Methods : In this experiment, we investigate the Inhibitory effects of UD on bone resorption using the bone cells culture. Different concentrations of crude extract of UD were added to mouse bone cells culture. The mitochondria activity of the bone cells after exposure was determined by colorimetric MIT assay. It was demonstrated that UD has potential effects on bone cells culture without any cytotoxicity. The most effective concentration of UD on bone cells were $100\;{\mu}g/ml$. Cathepsin K (Cat K) is the major cysteine protease expressed in osteoclasts and is thought to play a key role in matrix degradation during bone resorption. Results : When mouse long bone cells including osteoclasts and osteoblast were treated with the PI3-Kinase inhibitor, wortmannin (WT), WT prevented the osteoclast-mediated intracellular processing of Cat K. Similarly, treatment of osteoclasts-containing long bone cells with UD extracts prevented the intracellular maturation of Cat K, suggesting that UD may disrupt the intracellular trafficking of pro Cat K. This is similar to that of WT. Since secreted proenzymes have the potential to reenter the cell via mannose-6-phosphate (M6P) receptor, to prevent this possibility, we tested WT and UD in the absence or presence of M6P. Inhibition of Cat K processing by WT or UD was observed in a dose-dependent manner. Furthermore, the addition of M6P resulted in enhanced potency of WT and UD. Conclusion : UD dose-dependently inhibited in vitro bone resorption with a potency similar to that observed for inhibition of Cat K processing.

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Socket preservation using eggshell-derived nanohydroxyapatite with platelet-rich fibrin as a barrier membrane: a new technique

  • Kattimani, Vivekanand Sabanna;Lingamaneni, Krishna Prasad;Kreedapathi, Girija Easwaradas;Kattappagari, Kiran Kumar
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.6
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    • pp.332-342
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    • 2019
  • Objectives: Socket grafting is vital to prevent bone resorption after tooth extraction. Several techniques to prevent resorption have been described, and various bone graft substitutes have been developed and used with varying success. We conducted this pilot study to evaluate the performance of nanohydroxyapatite (nHA) derived from chicken eggshells in socket preservation. Materials and Methods: This was a prospective, single center, outcome assessor-blinded evaluation of 23 sockets (11 patients) grafted with nHA and covered with platelet-rich fibrin (PRF) membrane as a barrier. Bone width and radiographic bone density were measured using digital radiographs at 1, 12, and 24 weeks post-procedure. Postoperative histomorphometric and micro-computed tomography (CT) evaluation were performed. The study protocol was approved by the Institutional Ethics Committee. Results: All patients had uneventful wound healing without graft material displacement or leaching despite partial exposure of the grafted socket. Tissue re-epithelialized with thick gingival biotype (>3 mm). Width of the bone was maintained and radiographic density increased significantly with a trabecular pattern (73.91% of sockets) within 12 weeks. Histomorphometric analysis showed 56.52% Grade 3 bone formation and micro-CT analysis revealed newly formed bone with interconnecting trabeculae. Conclusion: Use of a PRF membrane with nHA resulted in good bone regeneration in sockets. Use of a PRF membrane prevents periosteal-releasing incisions for primary closure, thereby facilitating the preservation of keratinized mucosa and gingival architecture. This technique, which uses eggshell-derived nHA and PRF membrane from the patient's own blood, is innovative and is free of disease transfer risks. nHA is a promising economic bone graft substitute for bone regeneration and reconstruction because of the abundant availability of eggshell waste as a raw material.

Correlation Analysis of Sports injuries and Body Composition and Bone Density in National Water Pool Players (국가대표 수구선수들의 스포츠 손상과 신체 조성 및 골밀도의 상관관계 분석)

  • Kim, Hyun-Chul;Park, Ki-Jun
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.3
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    • pp.134-141
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    • 2019
  • PURPOSE: This study conducted aA forward-looking study of elite water polo athletes, who trained at National Training Center, was conducted to determine the correlation between the incidence of sports injuries and the bone density among national water polo players. METHODS: Data on the general characteristics of all study subjects were analyszed usingin descriptive statistics. The incidence of sports injuries was calculated from the incidence of sports injuries per 1,000 hours and the incidence of sports injuries resulting from exposure to 1,000 training sessions. The incidence of all sports injuries was calculated with a 95% confidence interval. Furthermore, Pearson's correlation was calculated conducted to determine the correlation between sports injuries and bone density, bone mass and body composition. RESULTS: Water polo athletes suffered a total of 127 sports injuries in the three-year period, while the athletes suffered 3.5 sports injuries each year. The Ooverall injury rate of 3.2(95% CI 2.68-3.81) per 1,000h, 18.0(15% CI 14.89-21.16) of sports injuries per 1,000AE. For all athletes, 50.4% of the injuries were classified as mild, followed by moderate (26.8%) and severe (22.8%). The lower the bone density in all areas of sports injuries, the higher the incidence of sports injuries. In addition, and the lower the bone mass in all areas except for light injuries, the higher the incidence of sports injuries. CONCLUSION: In tThe correlation between sports injuries and bone density and bone composition of water polo athletes, revealed a significant correlation between the bone density and bone mass were statistically significant, and the lower the bone density and bone mass, the higher the incidence of sports injuries.

Effects of Soy and Isoflavones on Bone Metabolism in Growing Female Rats (성장기 암컷 쥐에서 콩 단백질과 Isoflavones가 골 대사에 미치는 영향)

  • 최미자;조현주
    • Journal of Nutrition and Health
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    • v.36 no.6
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    • pp.549-558
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    • 2003
  • The purpose of this study was to determine which differences in the source of protein (soy vs casein) and isoflavones in soy protein are responsible for the differential effects of bone marks and hormones in growing female rats. Forty-two 21-day-old Sprague-Dawley female rats were randomly assigned to one of three groups, consuming casein (control group), soy protein isolate (57 mg isoflavones/100 g diet), or soy protein concentrate (about 1.2 mg isoflavones/100 g diet). All rats were fed on experimental diet and deionized water ad libitum for 9 weeks. Bone formation was measured by serum osteocalcin and alkaline phosphatase (ALP) concentrations. And bone resorption rate was measured by deoxypyridinoline (DPD) crosslinks immunoassay and corrected for creatinine. Serum osteocalcin, growth hormone, estrogen and calcitonin were analyzed using radioimmunoassay kits. Diet did not affect weight gain and mean food intake. Food efficiency ratio was lower in the soy protein groups. The soy isolate group had a higher ALP and osteocalcin concentration and lower crosslinks value than the casein group. Therefore, the soy isolate groups had a higher bone formation/resorption ratio than the casein group. And, the soy group had significantly higher growth hormone than the casein group. The findings of this study suggest that soy protein and isoflavones are beneficial for bone formation in growing female rats. Therefore, exposure to these soy protein and isoflavones early in life may have benefits for osteoporosis prevention.