• 제목/요약/키워드: Bone tissue

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즉시 식립 임플란트의 일차폐쇄를 위한 연조직 처치 (Soft-tissue management for primary closure in immediate implant placement)

  • 김강우;이재관;엄흥식;장범석
    • Journal of Periodontal and Implant Science
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    • 제38권2호
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    • pp.253-262
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    • 2008
  • Background: Incomplete flap coverage or early exposure over implants and/or barrier membranes have a negative effect on bone regeneration. In cases of using regenerative techniques, complete soft tissue coverage of the implant area is necessary to promote adequate conditions for guided bone regeneration. Primary socket closure may be difficult, when periosteal releasing incision is only used, due to the opening left by extracted tooth. Therefore, Soft tissue grafting techniques are used to achieve primary soft tissue closure. Materials and Methods: Soft tissue grafting techniques, with or without barrier membranes, were performed for primary closure in four cases of immediate placements. Three different methods were used (CTG, VIP-CT, Palatal advanced flap). Clinical results of the grafting were evaluated. Result: One case showed early exposure of cover-screw and, no other complications were noted. In the others, Primary closure was achieved by soft tissue grafting techniques. One of the cases, Graft showed partial necrosis, but there were no exposure over implants and/or barrier membranes. Conclusion: The use of grafting techniques, in immediate implant placement, can predictably obtain primary closure of extraction sockets, thereby providing predictable bone formation and improved implant results.

진행성 반안면위축환자의 치험례 (A Case Report of Progressive Hemifacial Atrophy)

  • 최문기
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권4호
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    • pp.344-350
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    • 2010
  • A progressive hemifacial atrophy is characterized by progressive atrophy of subcutaneous fat and rarely muscle and bone. Its contour follows the underlying muscle. Unilateral involvement is common. The treatment goal has been focused on the augmentation of the soft tissue. Many materials such as implants, collagen, fat graft, fat injection, dermal fat graft, filler and vascualized autogenous graft have been used. Although these materials have been used, the best treatment hasn't been achived. In severe cases underlying soft tissue, muscle and bone may be atrophied and massive soft tissue graft, implant and orthognathic surgery must be used. The author used the dermal-fat tissue for the pupose of soft tissue augmentation. We can get the massive soft tissue by the dermolipectomy procedure through the mini-abdominoplsty. The facial augmentation was done by augmentation of the dermal-fat tissue. The progressive hemifacial atrophy is hard to treat by only one procedure and many modalites must be considered.

이차적인 연부조직 손상을 동반한 종골 골절에 대한 유관 나사 및 단순 환상 강선 고정술을 이용한 치료: 2예 보고 (Treatment of Secondary Soft Tissue Compromised Calcaneus Fractures Using a Cannulated Screw and Simple Cerclage Wiring: A Report of Two Cases)

  • 김준겸;서재완
    • 대한족부족관절학회지
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    • 제21권4호
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    • pp.165-169
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    • 2017
  • Secondary soft tissue injuries can occur from the pressure of the displaced fragment of posterior calcaneal tuberosity in calcaneal tongue-type fractures and calcaneal tuberosity avulsion fractures. The soft tissue injury can be prevented by immediate reduction of the displaced fragments. Various techniques can be used to fix the fracture fragments, but the stability of fixation and minimal invasiveness to soft tissue should be considered. This paper reports the successful outcomes of patients with soft tissue compromises in calcaneal tongue-type fractures and calcaneal tuberosity avulsion fractures. The fixation technique of a large cannulated screw and simple cerclage wiring is believed to be a useful surgical option for the treatment of secondary soft tissue compromised calcaneal fractures.

치조골 재생술에 사용되는 동종골 처리방법에 대한 고찰 (REVIEW OF METHODS FOR PROCESSING ALLOGRAFTS FOR ALVEOLAR BONE RECONSTRUCTION)

  • 이은영;김경원;엄인웅
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권4호
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    • pp.366-371
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    • 2007
  • Evaluation of the methods of processing allogenic bone must be considered in order to make an effective choice of graft materials in oral surgery. Allograft materials processed by the tissue banking industry have varying capacities of bone reconstruction. The biological function of processed bone can be affected by many factors, like particle size, processing parameters, and inclusion or exclusion of mineral and moisture. For example, freeze drying step offers a safe and economical means for packaging, shipping, storage, and preservation of homologous bone. Demineralization of cortical bone using hydrochloric acid can produce a uniform demineralized surface with a capacity for osteoinduction. The objectives of this review were to evaluate the processing methods for allogenic bone and to characterize processed materials for grafting. It is important to understand the biological, biomechanical healing of different types of allografts to make the right choice for allogenic bone on each clinical application and to achieve a successful outcome for alveolar bone reconstruction in oral surgery.

파괴된 치주조직의 재생촉진에 관한 연구 (A STUDY OF REGENERATION ENHANCEMENT OF DESTRUCTED PERIODONTAL TISSUE)

  • 한경윤
    • Journal of Periodontal and Implant Science
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    • 제25권2호
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    • pp.407-417
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    • 1995
  • In order to evaluate the effect of platelet-derived growth factor(PDGF-BB) and guided tissue regeneration(GTR) technique on the regeneration of destructed periodontal tissue,intentional through-and-through furcation defects(4mm in height) were made on both mandibular 2nd and 4th premolars of 8 adult male dogs(30-40lb). Experimental group 1 was composed of the premolars that were treated by only topical application of PDGF-BB with 0.05M acetic acid without any barrier membrane. Experimental group 2 was composed of the premolars that were treated by GTR with expanded polytetrafluoroethylene membrane(ePTFE : Gore-tex periodontal material, USA). Experimental group 3 was composed of the premolars that were treated by GTR with ePTFE after topical application of PDGFBE. Control group was composed of the premolars that were treated by coronally positioned flap operation only without use of PDGF-BB and ePTFE membrane. All ePTFE membranes were carefully removed 4 weeks after regenerative surgery, and all experimental animals were sacrificed 8 weeks after regenerative surgery. The light microscopic findings were as follows ; (1) In experimental group 1, rapid new bone formation along the-root surface with multiple ankylosis and root resorption by multinucleated giant cells, and dense connective tissue in the central portion of the furcation defects were observed. (2) In experimental group 2, it was observed that the furcation defects were filled with newly formed bone, Sharpey's fibers were embedded into new cementum on root dentin of furcation fornix area, but the central portion and the area under furcation fornix were still filled with dense connective tissue. (3) In experimental group 3, the furcation defects were regenerated with newly formed dense bone and regular periodontal ligament with Sharpey's fibers embedded into newly formed cementum and bone underneath fornix area. (4) In control group, unoccupied space, apical migration of epithelium, dense infiltration of inflammatory cells in subepithelial connective tissue in relation to heavy plaque accumulation, and root resorption by inflammatory reaction were shown, but any new cementum formation on resorbed dentin surface could not be observed. The present study demonstrated that the combined therapy of PDGF-BB and GTR could enhance the regeneration of destructed periodontal tissue.

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가토 두개골 결손 모델에서 Bioglass가 첨가된 불소화 수산화인회석의 골재생능력 (Bone regeneration of the fluoridated hydroxyapatite and the bio-glass in the rabbit cranium defect model)

  • 안효준;한세진;김경욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권5호
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    • pp.380-385
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    • 2011
  • Introduction: Hydroxyapatite ($Ca_{10}(PO_4)_6(OH)_2$, HA) is the main inorganic phase of human hard tissue that is used widely as the repair material for bones. When HA is applied to a bony defect, however, it can be encapsulated with fibrous tissue and float in the implanted area due to a lack of consolidation. Bioceramics as allogenic graft materials are added to HA to improve the rate and bone healing capacity. Fluoridated hydroxyapatite ($Ca_{10}(PO_4)_6(OH,F)_2$, FHA), where F- partially replaces the OH- in hydroxyapatite, is considered a good alternative material for bone repair owing to its solubility and biocompatibility. Materials and Methods: This study was designed to determine the bone healing capacity of FHA newly produced as a nanoscale fiber in the laboratory. HA and FHA with bioglass was implanted in a rabbit cranium defect and the specimen was analysed histologically. Results: 1. At 4 weeks, fibrous connective tissue and little bone formation was observed around the materials of the experimental group I implanted HA and bioglass. Newly formed bone was observed around the materials in the experimental group II implanted FHA and bioglass. 2. At 8 weeks, the amount of newly formed and matured bone was higher in experimental group II than in experimental group I and the control group. Conclusion: These results suggest that FHA and bioglass is a relatively favorable bone substitute with biocompatibility and better bone healing capacity than pure HA and bioglass.

Radiation effect on peri-implant tissue after implantation

  • Kweon, Hyeog-Sin;Song, Kwang-Yeob
    • 대한치과보철학회지
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    • 제38권3호
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    • pp.291-309
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    • 2000
  • Statement of problem. There were several studies on the effects of irradiation to peri-implant bone tissue. However, no clear biological effect of irradiation on peri-implant bone tissue was reported yet. Purpose. This study compared the effect of irradiation on the surrounding tissue of a HA-coated implant fixture with controls. Material and methods. 6 Steri-Oss implants were implanted into the femur of 6 mongrels. The implanted dogs were divided into three groups and received irradiation. After 1 month, 2months and 4 months healing period, the histologic examination and mobility test and digital radiographic imaging analyses were performed to compare the control and experimental group respectively. Results. The irradiated group showed slower healing than control group in light microscopic observations. The mobility test demonstrated significant less number (Periotest) in control group than that of irradiated groups. The digital radiographic imaging analysis showed that the bone density of irradiated group was higher than control group. Conclusion. Generally, control group showed favorable biological response and less mobility than irradiated group. The conflict result of bone density value were measured by the digital radiographic imaging analysis. The digital radiographic imaging analysis needs more research in future.

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천공형 티타늄 막의 조기 노출이 수직 골 형성에 미치는 영향 (The effect of early membrane exposure on exophytic bone formation using perforated titanium membrane)

  • 김은정;허익;권영혁;박준봉;정종혁
    • Journal of Periodontal and Implant Science
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    • 제37권2호
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    • pp.237-249
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    • 2007
  • This study was performed to evaluate the effect of membrane exposure on new bone formation when guided bone regeneration with perforated titanium membrane on atrophic alveolar ridge. The present study attempted to establish a GBR model for four adult beagle dog premolar. Intra-marrow penetration defects were created on the alveolar ridge(twelve weeks after extraction) on the mandibular premolar teeth in the beagle dogs. Space providing perforated titanium membrane with various graft material were implanted to provide for GBR. The graft material were demineralized bovine bone(DBB), Irradiated cancellous bone(ICB) and demineralized human bone powder(DFDB). The gingival flap were advanced to cover the membranes and sutured. Seven sites experienced wound failure within 2-3weeks postsurgery resulting in membrane exposure. The animals were euthanized at 4 weeks postsurgery for histologic and histometric analysis. The results of this study were as follows: 1. There was little new bone formation at 4 weeks postsurgery. irrespectively of membrane exposure. 2. There was significant relationship between membrane exposure and bone graft resorption(P<0.05), but no relation between membrane exposure and infiltrated connective tissue. 3. There was much bone graft resorption on DFDB than ICB and DBB. 4. The less exposure was on the perforated titanium membrane, the more dense infiltrated connective tissue was filled under the membrane when grafted with ICB and DBB. but there was no relationship between the rate of membrane exposure and the percentage of infiltrated connective tissue area and no relationship between the percentage of the area in the infiltrated connective tissue and in the residual bone graft. Within the above results, bone formation may be inhibited when membrane was exposed and ICB and DBB were more effective than DFDB as a bone graft material when guided bone regeneration.