• Journal of Korean Dental Science
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• v.4 no.2
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• pp.59-66
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• 2011

Purpose: This research sought to determine the resorption rate of bone grafted to the maxillary sinus according to the grafted material's type, patient's age, systemic disease, implant size, site of implant placement, and residual ridge height. Materials and Methods: This research targeted 24 patients who had immediate Osstem$^{(R)}$ implant (US Plus$^{(R)}$) placement after bone graft. The panorama was taken before the surgery, after the surgery, and 6 months after the surgery. Vertical height change and resorption rate of the grafted bone were measured with the same X-rays and compared. The influence of the following factors on the grafted bone material's resorption rate was evaluated: grafted material type, patient's age, systemic disease, implant size, site of implant placement, and residual ridge height. Results: Patients in their 40s had $34.0{\pm}21.1%$ resorption rate, which was significantly higher compared to the other age groups (P<0.05). There was no significant relationship between systemic disease and grafted bone resorption. There was no significant relationship between implant size (diameter, length) and grafted bone resorption. There was no significant relationship between the site of implant placement and grafted bone resorption. The ramal bone-grafted site was significantly more resorbed than the ramal bone/Bio-Oss$^{(R)}$-grafted site, maxillary tuberosity bone/Bio-Oss$^{(R)}$-grafted site, and ramal bone/maxillary tuberosity bone/Bio-Oss$^{(R)}$-grafted site (P<0.05). There was no significant difference in the grafted bone resorption rate in the sinus between more than 4 mm and less than 4 mm residual ridge heights. After an average of 6 months, a second surgery was done; given an average follow-up of 1.9 years, the success rate and survival rate of the implant were 96.9% and 98.4%, respectively. Conclusion: These results indicate that the bone resorption rate of grafted bone among patients in their 40s is higher compared to patients in their 50s and over, and that only autogenous bone (ramus) shows higher resorption rate than the mixed graft of autogenous bone and xenogenous graft (Bio-oss) after maxillary sinus graft.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.353-359
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• 2010

Introduction: This study examined the effect of cyclosporine A (CsA) on the allogenic cranial bone graft in the mice. Materials and Methods: Twenty eight 12-week-old male ICR mice weighing 40 g were used. The experimental group was injected subcutaneously with CsA (10 mg/kg/day) diluted in Caster oil for 7 days prior to the graft until sacrifice. The control group was injected with the same solution without CsA. Two full-thickness bone defects with a diameter of 3 mm were made with a trephine bur in the parietal bone lateral to the sagittal suture. A calvarial defect of a mouse was grafted with allogenic calvarial bone disc from another mouse. The experimental and control groups were injected with CsA and the solution without CsA in the same manner before surgery, respectively. The mice were sacrificed at 1 week, 2 weeks and 4 weeks after the bone graft, respectively. Results: In the experimental group, fibrous connective tissues and small amounts of inflammatory cells were observed. At 2 weeks after the allograft in the experimental group, new bone formation in fibrous collagenous tissue and around the allogenic bone was noted. At 4 weeks after the allograft, new bone formation was active along and at the periphery of the mature allogenic bone. The proliferation of blood vessels increased in bone marrow. In the control group, fibrous tissues and inflammatory cells were observed around the allogenic bone and existing bone at 1 week. At 2 weeks after the allograft, the proliferation of blood vessels accompanied by inflammatory cells were scattered in the fibrous connective tissues. New bone formation around the allogenic and existing bone could be observed. At 4 weeks after the allograft, inflammatory cells were severely infiltrated around the allogenic bone. Osteoclasts were scattered along the allogenic bone and induced bone resorption. Conclusion: These results suggest that the daily administration of CsA (10 mg/kg/day) induces efficient immunosuppression without serious complications, and this protocol might be useful for the experimental model of allogenic bone grafts.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.1
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• pp.86-91
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• 2000

Autogenous bone graft is the useful technique for management of various bone defect in oral and maxillofacial surgery. The most common site for bone graft harvest is the anterior iliac crest. There is usually considerable cancellous bone graft available and it can be obtained with minimal morbidity. However, complications noted in iliac crest grafts include prolonged postoperative pain, hematoma and fracture, gluteal muscle weakness. Occasionally, when large amounts of bone graft are needed and previous harvest procedure had used, iliac bone harvest may be not adequate. Like the iliac crest, the greater trochanter has abundant cancellous bone and is readily accessible with acceptable morbidity. The purpose of this study was to assess the availability of cancellous bone graft from the greater trochanter, compare the quantity with that available from the anterior iliac crest, investigate anatomical hazards, and make recommendations for consistent harvest.

• Archives of Craniofacial Surgery
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• v.19 no.3
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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.

• Journal of Korean Dental Science
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• v.3 no.2
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• pp.4-11
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• 2010

Purpose: This study aimed at examining the thickness of lateral cortical bone in the mandibular posterior body and the location of the inferior alveolar nerve canal as well as investigating the clinically viable bone grafting site(s) and proper thickness of the bone grafts. Subjects and Methods: The study enrolled a total of 49 patients who visited the Department of Oral and Maxillofacial Surgery at Kyung Hee University Dental Hospital to have their lower third molar extracted and received cone beam computed tomography (CBCT) examinations. Their CBCT data were used for the study. The thickness of lateral cortical bone and the location of inferior alveolar nerve canal were each measured from the buccal midpoint of the patients' lower first molar to the mandibular ramus area in the occlusal plane of the molar area. Results: Except in the external oblique ridge and alveolar ridge, all measured areas exhibited the greatest cortical bone thickness near the lower second molar area and the smallest cortical bone thickness in the retromolar area. The inferior alveolar nerve canal was found to be located in the innermost site near the lower second molar area compared to other areas. In addition, the greatest thickness of the trabecular bone was found between the inferior alveolar nerve canal and the lateral cortical bone. Conclusions: In actual clinical settings involving bone harvesting in the posterior mandibular body, clinicians are advised to avoid locating the osteotomy line in the retromolar area to help protect the inferior alveolar nerve canal from damage. Harvesting the bone near the lower second molar area is judged to be the proper way of securing cortical bone with the greatest thickness.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.2
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• pp.137-152
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• 1995

This study was designed to evaluate the bone formation capability of the bone substitute when compared with autogenic bone, freeze-dried demineralized allogeneic bone and bioglass into parietal bone of the rats. We made the parietal bone defects in $7{\times}7mm$ size on rats and has performed the bone graft in each experimental groups. Postoperatively 1, 2, 4, 6, 8, weeks, each specimen stained with H & E, Masson's trichrome methods. We evaluated the osteogensis capability in each groups. The result were as follow : 1. Inflammatory cell infiltration approached at 1 week and disappeared at 4 weeks in all experimental group, expecially severe in freeze-dried demineralized allogeneic bone group. 2. New capillry proliferation was increased in autogeneic bone graft group than any other groups and was increased till 2 weeks and decreased in freeze-dried demineralized allogeneic bone group and was few in bioglass group. 3. Osteoblastic activity increased in autogeneic bone and freeze-dried demineralized allogeneic bone groups till 4 weeks, and decreased in 6 weeks which no difference between these groups. But, few occurred in bioglass group till 6 weeks. 4. Initial osteoclastic activity was prominent in freeze-dried demineralized allogeneic bone group and few in autogeneic bone group. 5. New bone formation bega at 1 week in autograft and freeze-dried demineralized allogenic bone groups, but, mild new bone formation at 8 weeks in bioglass.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.274-282
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• 2013

Objectives: The posterior maxillary region often provides a limited bone volume for dental implants. Maxillary sinus elevation via inserting a bone graft through a window opened in the lateral sinus wall has become the most common surgical procedure for increasing the alveolar bone height in place of dental implants in the posterior maxillary region. The purpose of this article is to assess the change of bone volume and the clinical effects of dental implant placement in sites with maxillary sinus floor elevation and autogenous bone graft through the lateral window approach. Materials and Methods: In this article, the analysis data were collected from 64 dental implants that were placed in 24 patients with 29 lacks of the bone volume posterior maxillary region from June 2004 to April 2011, at the Department of Oral and Maxillofacial Surgery, Inha University Hospital. Panoramic views were taken before the surgery, after the surgery, 6 months after the surgery, and at the time of the final follow-up. The influence of the factors on the grafted bone material resorption rate was evaluated according to the patient characteristics (age and gender), graft material, implant installation stage, implant size, implant placement region, local infection, surgical complication, and residual alveolar bone height. Results: The bone graft resorption rate of male patients at the final follow-up was significantly higher than the rate of female patients. The single autogenous bone-grafted site was significantly more resorbed than the autogenous bone combined with the Bio-Oss grafted site. The implant installation stage and residual alveolar height showed a significant correlation with the resorption rate of maxillary sinus bone graft material. The success rate and survival rate of the implant were 92.2% and 100%, respectively. Conclusion: Maxillary sinus elevation procedure with autogenous bone graft or autogenous bone in combination with Bio-Oss is a predictable treatment method for implant rehabilitation.

• Archives of Reconstructive Microsurgery
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• v.15 no.1
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• pp.26-32
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• 2006

Purpose: The purpose of this study was to evaluate the effectiveness of limb reconstruction and functional recovery using vascularized fibular graft in the treatment of extensive bone defect of long bone caused by various diseases. Materials and Methods: From september 1995 to March 2005, 21 patients with segmental bone defects were managed with vascularized fibular graft: 13 males and 8 females, aged 39 years on average (range, $8{\sim}65\;years$). The reconstructed site was the humerus in 9 patients, the femur in 5, the tibia in 4 and the forearm bone in 3. The length of bone defect ranged from $8{\sim}17\;cm$. Results: Twenty grafts were successful. The mean period to obtain radiographic bone union was 5.7 months on average. Conclusion: Fibular grafts allow the use of a segment of diaphyseal bone and of sufficient length to reconstruct most skeletal defects of the long bone. The vascularized fibular graft is indicated in patients with intractable nonunions where conventional bone grafting has failed or large bone defects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.3
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• pp.117-122
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• 2014

Objectives: The purpose of this study was to evaluate the sinus bone graft resorption over 3 years after two-stage implant placement. Materials and Methods: The subjects for this study included 30 patients whose maxillary posterior ridges were too atrophic for implants. Bone-added osteotome sinus floor elevation was used in 15 maxillary sinuses, while the bone graft by lateral approach technique was used in 25 maxillary sinuses. The height from the top of the fixture to the sinus floor was estimated immediately after implant placement and the follow-up period was over 3 years. The surgery was classified with two groups: sinus bone grafting with and without autogenous bone. All implants were placed simultaneously. Results: The mean vertical bone loss was $3.15{\pm}2.95mm$. The survival rate of implants was 94.7%. Conclusion: The amount of bone resorption was not significantly associated with the surgical methods, the type of bone graft materials used, or sinus perforation during surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.45.1-45.7
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• 2016

Background: We evaluated and compared the outcomes of different ossification processes in patients with alveolar cleft in whom correction was performed using endochondral bone graft or intramembranous bone graft. Methods: The patients were divided into two groups: the endochondral bone (iliac bone or rib bone) graft group and the intramembranous bone (mandibular bone) graft group. Medical records and radiologic images of patients who underwent alveolar bone grafting due to alveolar cleft were analyzed retrospectively. Through postoperative and follow-up radiologic images, the height of the interdental bone septum was classified into four types based on the highest point of alveolar ridge. Then, the height of the interdental bone septum and the area of the bone graft were evaluated according to the type of bone graft. In addition, the occurrence of complications and the need for an additional bone graft, the result of postoperative orthodontic treatment, and the eruption of impacted teeth were investigated. Results: Thirty patients were included in this study. There was no significant difference in the change of the interdental bone height and the area of the bone graft according to the type of bone. There was no significant difference in the success rate of the surgery according to the type of bone. One patient underwent an additional bone graft surgery during the follow-up period. Conclusions: The outcomes of alveolar bone grafting were not significantly different according to the type of bone graft. If appropriate to the size of the recipient site, the chin bone is a useful graft material in alveolar cleft, as is the iliac bone.