• 대한족부족관절학회지
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• 제11권2호
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• pp.221-225
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• 2007

Purpose: To evaluate the clinical results of operative treatment of the intra-articular calcaneal fracture with injectable calcium sulfate ($MIIG^{TM}$). Materials and Methods: Between March 2004 and October 2006, a total 19 intra-articular calcaneal fracture (16 patients) with a large bony defect that underwent operative treatment with plate fixation and injectable calcium sulfate ($MIIG^{TM}$) with minimum follow-up of one year following. The mean age at time of surgery was 44.7 years (23 to 54). All of the cases were type 2 and 3 on the basis of Sanders classification. The lateral L shaped approach was used in all cases. Full weight bearing on the affected extremity was regained at an average 10 weeks postoperatively. Results: The mean Bohler angle was improved from $2^{\circ}$ ($-18.5{\sim}12.5^{\circ}$) preoperatively to $23.8^{\circ}$ ($12{\sim}37.5^{\circ}$) and the angle at last follow-up was $22.5^{\circ}$ ($11.5{\sim}37.5^{\circ}$), showing about 0.3 degree decline compared to postoperative Bohler angle. Only two case of whitish leakage of graft material but other complication were none. Conclusion: $MIIG^{TM}$ augumentation of displaced intra-articular calcaneal fracture with large bone defect seems to bo useful method for initial stabilized and plate fixation.

• 대한골관절종양학회지
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• 제6권2호
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• pp.106-111
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• 2000

국소적 섬유연골성 이형성증(FFCD)은 소아에서 일측성 경골 내반 소견을 보이는 드문 양성 질환이다. FFCD는 근위 경골 내측 골간단과 골간의 이행부에 오목한 방사선 투과 음영 소견을 보이는 전형적인 방사선 소견을 지니고 있다. 경골 내반이 병변 부위에서 발생한다. 내반의 교정과 골결손의 치유가 흔히 자발적으로 일어나기도 하지만 골교정술을 요하기도 한다. 저자들은 절제 조직 생검술로 진단하고 절골술 및 골이식술을 시행함으로써 치유한 FFCD에 의한 일측성 경골 내반 1예를 문헌고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.58-67
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• 2006

In the recent studies, many authors have reported that the success rate of immediate implantation has no difference compared to conventional staged implantation. Although the immediate implantation has many advantages over conventional approach, many clinicians don't seem to practice because they think that most of the extraction sockets will have some bony gab with defects around implant and that this situation makes the result of immediate implantation unpredictable. We clinically analyzed 23 implanted sites of 18 patients treated with immediate implantation in our hospital from September 2003 to January 2004. The $ITI^{(R)}$. dental implant system was used and GBR procedure with $Bio-Oss^{(R)}$. and $Bio-Gide^{(R)}$. was done simultaneously. The pre & post-op. measurements were recorded such as alveolar crest-adjacent tooth CEJ distance, gingival crest-adjacent tooth CEJ distance, existence of periapical lesion, vertical defect around the extraction socket, horizontal defect around the extraction socket, probing depth, radiologic change of alveolar crest height. We report a positive outcome about immediate implantation with review of literatures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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• pp.254-261
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• 2000

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regenerated bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1994 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권5호
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• pp.299-310
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• 2012

Purpose: The purpose of this study was to evaluate the histological healing process of 3 different types of xenogenic tooth bone graft material and xenogenic bone graft material. Methods: Three types of human tooth bone graft material (chips, crowns, and roots) and BioOss (Geistlich Pharma AG, Wolhausen, Switzerland) was filled at the preformed 4 round-shaped calvarial bone defects of beagle dogs. The beagles were sacrificed at 2, 4, 8, and 12 weeks, respectively, for radiological and histological evaluation. Results: Increased strength and radiopacity were detected in all graft material groups in time-dependent manner. New bone was formed and matured surrounding the graft material histologically. Also, a new bone was directly integrated with graft material. Conclusion: It was expected that newly developed tooth bone graft material would show good bone healing capacity if it was used as a graft material for the restoration of bony defect.

• Journal of Periodontal and Implant Science
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• 제25권2호
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• pp.341-356
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• 1995

The purpose of this study was to evaluate the effect of demineralized freeze dried bone and demineralized bone gel with guided tissue regeneration treatment around titanium implants with dehisced bony defects and also evaluate space maintaining capacity of demineralized bone gel type and DFDB powder type under e-PTFE membrane. In 3 Beagle dogs, mandibular premolar was extracted and four peri-implant osteotomies were formed for dehiscence. After insertion of implants, the four peri-implant defects were treated as follows. 1) In control group. no graft material and barrier membrane were applied. 2) In experimental group.1, the site was covered only with the e-PTFE membrane. 3) In experimental group 2,received DFDB powder and covered by the e-PTFE membrane. 4) In experimental group 3, demineralized bone gel and e-PTFE membrane were used. By random selection, animals were sacrificed at 4, 8, 12 weeks. The block sectioned specimens were prepared for decalcified histologic evaluation(hematoxylin and eosin staining) and undecalcified histologic evahiation(Von Kossa's and toluidine blue staining) with light microscopy. The results of this study were as follows. 1) In control group, there was a little new bone formation and connective tissue was completely filled in the defect area. 2) Experimental group 1 showed lesser quantity of bone formation as compared to the bone grafted group. Thin vertical growth of new bone formation around implant fixture was shown. 3) Experimental group 2 showed thick bucco-lingual growth of new bone formation and grafted bone particles were almost resorbed in 12 week group. 4) In experimental group 3, most grafted bone particles were not resorbed in 12 week group and thick bucco-lingual bone formation was shown in dehisced defect base area. 5) There was no remarkable differences in space making capacity and new bone formation procedure between demineralized freeze-dried bone powder type and demineralized bone gel type.

• Archives of Reconstructive Microsurgery
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• 제6권1호
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• pp.63-72
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• 1997

We have evaluated the clinical results following the 46 cases of free vascularized osteocutaneous fibular flap transfer to the tibial defect combined with skin and soft tissue defect, which were performed from May 1982 to January 1997. Regarding to the operation, flap size, length of the grafted fibula, anastomosed vessels, ischemic time of the flap and total operation time were measured. After the operation, time to union of grafted fibula and the amount of hypertrophy of grafted fibula were periodically measured through the serial X-ray follow-up and also the complications and results of treatment were evaluated. In the 46 consecutive procedures of free vascularized osteocutaneous fibular flap transfer, initial bony union were obtained in the 43 grafted fibulas at average 3.75 months after the operation. There were 2 cases in delayed unions and 1 in nonunion. 44 cutaneous flaps among the 46 cases were survived but 2 cases were necrotized due to deep infection and venous insufficiency. One necrotized flap was treated with latissimus dorsi free flap transfer and the other was treated with soleus muscle rotational flap. Grafted fibulas have been hypertrophied during the follow-up periods. The fracture of grafted fibula(15 cases) was the most common complication and occurred at average 9.7 months after the operation. The fractured fibulas were treated with the cast immobilization or internal fixation with conventional cancellous bone graft. In the cases of tibia and fibula fracture at recipient site, the initial rigid fixation for the fibula fracture at recipient site could prevent the fracture of grafted fibula to the tibia.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권5호
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• pp.431-437
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• 2005

Fibrin glue is composed of fibrinogen and thrombin and used in various regions for multiple use. Basic principle is that thrombin converts fibrinogen to fibrin in the presence of $Ca^{2+}$. The structure of fibrin is loose at the beginning, but after about 5 minutes a tight structure is formed under the influence of factor VIII which changes fibrin monomer into fibrin polymer. Fibrin glue is used for tissue adhesive, suture, local hemostasis, wound healing, closure of subdural space. Fibrin adhesive has been used in oral and maxillofacial surgery for hemostasis after tooth extraction in patients with coagulation disorders, skin graft fixation, reattachment of periodontal flaps, in combination with autogenous bone chips to fill the bony cavities following cyst removal, and for securing the hydroxyapatite granules for maxillary alveolar ridge augmentation. This study was designed for researching influence of fibrin glue during healing phase after making artificial bone defect.

• Archives of Reconstructive Microsurgery
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• 제13권2호
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• pp.136-143
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• 2004

Purpose : We analyse retrospectively the clinical result of consecutive free flap and osteocutaneous flap transfer in the chronic osteomyelitis, nonunion combined with infection and soft tissue defect with infection. Materials and Methods : From December 1989 to Jun 2003, free flap and osteocutaneous flap transfer was performed in 225 patients with osteomyelitis or infected non-union. 44 cases of these patients had revealed antibitotics resistant organism in wound culture, and these 44 cases were investigated in the mechanism of the injury, recurrence of infection, radiographic union, follow-up clincal results, and postoperative complications. Results : Among the 44 cases, consecutive procedures of osteocutaneous flap transfers(26 cases) and free flaps(18 cases) were performed. Causative organisms were MRSA(20 cases), Pseudomonas aeruginosa(18 cases), acinetobacter(2 cases), and so forth. Initial bony union was obtained in the average 6.3 months. Recurrence of infection in free flap and osteocutaneous free flap were occurred in 3 and 4 cases respectively. Eventually, all the cases attained successful subsidence of the inflammation. Conclusion : Free flap and osteocutaneousflap transfer have provided the greatest improvement of surgical results in infected non-union, chronic osteomyelitis and soft tissue defect with infection. Further clincal studies maybe required to minimize failure rate.

• Journal of Periodontal and Implant Science
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• 제24권1호
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• pp.205-216
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• 1994

The goal of periodontal therapy is the regeneration of the periodontium lost by periodontal disease. The purpose of this study was to evaluate the regenerative potential of the autogenous bone graft and guided tissue regeneration in the treatment of periodontal bony defect in dogs. Experimental periodontitis were induced in the mandibular left 3rd premolar and right 3rd and 4th premolars of 5 dogs using orthodontic ligature wire. After 6 weeks, the ligature wire removed, surgical procedure were performed as follows. 1) control group : Flap operation(Mn.Lt 3rd premolar) 2) experimental group I : Flap operation + autogenous bone graft (Mn.Rt. 3rd premolar) 3) experimental group II : Flap operation + Gore-Tex membrane (Mn.Rt. 4th premoalr) Thereafter, dogs were sacrificed on the 1,2,4,8,16th week and the specimens were prepared and stained with hematoxyline-eosin stain for the light microscopic examination. The results of this study were as follows. 1. The apical migration of junctional epithelium was most remarkable in the flap operation and the experimental group II was less than the experimental group I. 2. In the formation of new alveolar bone, it was found in experimental group I,II and experimental group I is more than II. In the control group, few bone formation was found. 3. In the formation of new cementum, it was found in experimental group I,II and experimental group II is more than I. So, the periodontal therapy combined with autogenous and guided tissue regeneration will be produce the periodontal regeneration.