• The Journal of the Korean bone and joint tumor society
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• v.4 no.2
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• pp.81-87
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• 1998

Although autoclaved autogenous bone reconstruction is one of the established procedures, it may have some problems in bone regeneration and mechanical property. The purpose of this study is to evaluate the efficacy of more biologic and anatomical reconstruction where allograft is not readily available. From Aug.1991 to Feb. 1996 the authors analyzed 32 cases of reconstruction with autogenous low heat treated bone. Autogenous graft sites were humerus 4, tibia 4, pelvis 9, and 15 femur. Average follow-up period was 23(range;12-51) months. There were 49 graft-host junctional sites. Diaphysis was 22, metaphysis 10, and flat bone 17. Average duration of healing for the 38 united sites was 7 months. Average union time for each anatomical area 8 months in 19 diaphysis, 12 months in 7 metaphysis, and 12.7 months in 12 flat bone(pelvis). Eleven nonunion sites consisted of 3 diaphysis(3/22), 3 metaphysis(3/10), and 5 flat bone(5/17). Complications other than nonunion were local recurrence(4), bone resorption(3), graft fracture(2), osteomyelitis(1), metal failure(2), and wound infection(1). Initial bone quality and stable fixation technique was important for union rate. Plate and screw is a good method for diaphyseal lesion. Metaphyseal and flat bone are weak area for rigid fixation and one stage augmentation with iliac bone graft can be a salvage procedure.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.86-92
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• 2008

Purpose: To evaluate the safety and prognostic factors of intramedullary nailing of distal tibia fractures in terms of function and symptoms of the ankle joint. Materials and Methods: We retrospectively analyzed 22 distal tibial fractures with intramedullary nailing. The mean duration of follow-up was 43 months. We reviewed medical records to describe each case. We measured radiographic parameters such as fracture configuration, arthritic change of the ankle joint and status of reduction. We also assessed clinical results by AOFAS ankle hind foot scoring system, degree of pain by VAS and range of motion to find out prognostic factors for functional result of the ankle joint. Results: Bone healing was obtained in all cases without any wound complications. Mean AOFAS ankle score was 94. There were 4 cases with mild (VAS<3/10) ankle pain and 2 cases with mild limitation of ankle motion. The comminution of fracture had a significant relationship with delayed angular deformity of ankle joint (p=0.032). There was no other significant parameter affecting ankle joint function except the location of nail-end. Conclusion: Intramedullary nailing in distal tibia fracture is a safe and effective procedure. But further study may need to evaluate the relationship between the position of nail-end and the function of ankle joint.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.2
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• pp.116-120
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• 2024

External nasal splints are commonly used for immobilization following nasal fracture reduction or rhinoplasty procedures. The literature documents the use of various materials like thermoplastic materials, aluminum, Orthoplast, fiberglass, plaster of Paris, and polyvinyl siloxane. These materials are bulky, time-consuming, expensive, and cumbersome to use, and have been associated with complications including contact dermatitis and epidermolysis. Furthermore, they cannot be retained if the situation warrants prolonged stabilization and immobilization. We introduce a new technique using readily available scalp vein catheter flanges as an external nasal stent. The technique is easy to master, inexpensive, and limits edema and ecchymosis, while stabilizing the reconstructed nasal skeleton in position during the healing period.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.27-33
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• 2010

Purpose: Most clavicular fractures can be healed by conservative treatment, although there are many factors that influence healing. The aim of the present study was to analyze factors that influence (i) bone union of midshaft fractures of the clavicle treated conservatively and (ii) bone functioning, after union. The long-term goal was to determine which treatments are adequate. Materials and Methods: We evaluated factors that have an effect on bone union and bone function after union. We evaluated age, fracture site, comminution, displacement, shortening and other factors. Among 523 clavicular midshaft fractures that presented between January 2004 and Jun 2009 at our Department of Orthopaedic Surgery, we identified 270 who had conservative treatment and 173 patients who had surgical treatment. Results: The period required for bone union increased with the degree of displacement. For the group below 12 years of age, and the group without comminution, it took half the time to achieve bone union compared with the other groups. Displacement mostly occurred within 2 weeks after conservative treatment. Conclusion: In patients with a comminuted clavicular midshaft fracture, we might, because of expected delays in bone union, delay the start of rehabilitation until patients are more than 13 years old. Because the degree of displacement may be increased within 2 weeks during conservative treatment, we can think about surgical treatments.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.1
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• pp.23-26
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• 2010

The vascular changes in periodontal tissues cause local hypoxia which seems to affect the periodontal tissue cells. Abrupt changes in oxygen availability within the periodontium have been suggested to have a regulatory role in alveolar bone remodeling during tooth movement, bone growth or fracture healing. The purpose of this study was to study the effects of hypoxia on formation of osteoclast responsible for bone resorption, in vitro. Primary mouse bone marrow cells were cultured in normoxic (20% $O_2$) and hypoxic (1% $O_2$) conditions and assayed for cellular proliferation. The results obtained were as follows : 1. Reducing oxygen tension increased the formation of multinucleated osteoclasts. 2. Hypoxic stimulus increased the size of mature osteoclasts.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.794-805
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• 2020

Objective : Teriparatide is known as an effective anabolic agent not only for severe osteoporosis but also for bone healing and union. We explored the possibility of teriparatide as an alternative treatment option for osteoporotic thoracolumbar (TL) burst fracture. Methods : This retrospective study enrolled 35 female patients with mean age of 73.77±6.71 years (61-88) diagnosed as osteoporotic TL burst fracture with ≥4 of thoracolumbar injury classification and severity (TLICS) score and no neurological deficits. All patients were treated by teriparatide only (12 of group A), teriparatide plus vertebroplasty (12 of group B), or surgical fixation with fusion (11 of group C), and followed up for 12 months. Radiological outcomes were evaluated using radiological parameters including kyphotic angle (KA), segmental vertebral kyphotic angle (SVKA), compression ratio (CR), and vertebral body height (anterior [AH], middle [MH], posterior [PH]). Functional outcomes were evaluated using visual analog scale (VAS) and Macnab classification (MC). Results : There were no statistical significant differences in age, bone mineral density (-3.36±0.73), and TLICS score (4.34±0.48) among the three groups (p>0.05). Teriparatide was administered during 8.63±2.32 months in group A and B. In 12-month radiological outcomes, there were significant restoration in SVKA, CR, AH, and MH of group B and KA, SVKA, CR, AH, and MH of group C compared to group A with no radiological changes (p<0.05). All groups showed similar significant improvements in 12-month functional outcomes, although group B and C showed a better 1-month VAS, 1-month MC, 3-month MC compared to group A (p<0.05). Conclusion : Non-surgical treatment with teriparatide showed similar 12-month functional outcomes compared to surgical fixation with fusion. The additional vertebroplasty to teriparatide and surgical fixation with fusion were more helpful to improve short-term functional outcomes with structural restoration compared to teriparatide only.

• Journal of Periodontal and Implant Science
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• v.41 no.1
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• pp.23-29
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• 2011

Purpose: To investigate the healing pattern of the mucous membrane after tooth extraction necessitated by periodontal disease in the maxillary sinus. Methods: One hundred and three patients with 119 maxillary sinuses were investigated. Before implant placement, cone-beam computed tomography (CT) scanning was performed. The causes of extraction, the time elapsed since extraction, smoking, periodontal disease in adjacent teeth, and gender were recorded. In addition, the thickness of the mucous membrane of the maxillary sinus and the height of residual alveolar bone at the extracted area were calculated from CT images. Results: The thickness of the mucous membrane in the periodontal disease group ($3.05{\pm}2.71\;mm$) was greater than that of the pulp disease group ($1.92{\pm}1.78\;mm$) and the tooth fracture group ($1.35{\pm}0.55\;mm$; P<0.05). The causes of extraction, the time elapsed since extraction, and gender had relationships with a thickening of the mucous membrane of the maxillary sinus (P<0.05). In contrast, the height of the residual alveolar bone at the extracted area, periodontal disease in adjacent teeth, and smoking did not show any relation to the thickening of the mucous membrane of the maxillary sinus. Conclusions: The present study revealed distinct differences in healing patterns according to the causes of extraction in the maxillary sinus, especially periodontal disease, which resulted in more severe thickening of the mucous membrane.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.1
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• pp.37-41
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• 2017

Objectives: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results: In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion: If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.1-13
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• 1990

The main objectives of this study was to observe the effects of hyperbaric oxygen therapy on the healing processes of mandibular fracture of streptozotocin-induced diabetic rats. Author used 60 rats (Sprague-Dawley Strain) deviding into control(30) and experimental groups(30). Complete fracture was produced on the left mandibular body of 60rats, rendered hyperbaric oxygen therapy (2 hrs. daily at 2.5 atm.) on experimental group and observed effects of hyperbaric oxygen therapy by microscopically. The obtained results were as follows; 1. Infiltration of inflammatory cells was no significant differences between the control and experimental group until 3rd week, but experimental group showed decreasing tendency after 4th week. 2. Severe proliferation of fibroblasts showed rather rapider in experimental group, at 2nd week, while at 3rd week in control group. 3. Osteoclasts appeared at 1st week in experimental group while at 3rd week in control group, and experimental group showed early bone resorption pattern. 4. Osteoblasts appeared at 1st week in experimental group while at 3rd week in control group, and experimental group showed prominent osteoblastic activity. 5. Moderate proliferation of capillary blood vessels showed in initial stage of experimental group while mild proliferation at 1-2nd week in control group. 6. Formation of cartilaginous callus showed at 4th week in experimental group, while at 6th week in control group. 7. Formation of bony callus showed mildly at 5th week, and moderately at 6th week in experimental group, while no appearance in control group, but complete bony union was not observed even in experimental group throughout this experiment.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.89-112
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• 2002

The earliest reports of the use of electrical energy to directly stimulate bone healing seem to be in 1853 from England, the techniques involved the introduction of direct current into the non-united fracture site percutaneously via metallic needles, with subsequent healing of the defect. One endpoint of the periodontal therapy is to generate structure lost by periodontal diseases. Several procedural advances may support regeneration of attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical current which occurs in bone naturally, so that such bone may be particularly susceptible to electrical therapy. The purposes of this study were to observe the effects of electrical stimulation on the normal periodontium, to determine whether the electricity is the useful means for periodontal regeneration or not. Forty rats weighted about 100 gram were used and divided into 4 groups, the first group, there was no electrical stimulation with the connection of electrodes only. In the second group, there was stimulated by the 10 mA during 10 minutes per a day, in the third group was stimulated by the 25 mA , and the fourth by the 50 mA. At 3, 5, 10 and 15 days post-appliance , two rats in each group were serially sacrificed. and the maxillae and the mandible processed to paraffin, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was the distinct reversal line on the lingual alveolar crest, whereas a little changes in the labial alveolarcrest to the duration and amount of currents. 2. In 50 mA group, the cells were highly concentrated at the apex of anterior teeth, and was observed the necrotic tissue. In posterior root apex, the hypercementosis was appeared, and newly formed cementum layer has been increased continuously with the time. 3. The periodontal ligament fiber and Sharpey's fiber were arranged in order, and the bone trabeculae were increased as the experiment proceeded by, relatively the bone marrows were decreased. 4. In the pulp tissue, the blood vessels were increased with blood congestion in the experimetal specimens remarkably, and the dentinal tubules were obstructed . 5. The osteoblasts in alveolar bone proper had been showed highly activity, and also observed the formation of bone trabeculea. In the conclusion, it was suggested that the electrical stimulation has influence on the periodontium and the pulp tissue. However, there might be the injurious effects.