• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.567-577
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• 2006

Background Several bone grafting materials have been used in sinus augmentation procedures. Macroporous Biphasic Calcium Phosphate($MBCP^{TM}$) consists of the mixture of 60% HA and 40% ${\beta}-TCP$. Therefore, it can provide good scaffold for the new bone to grow owing to HA, in the other hand, it can have bioactivity for bone remodeling owing to ${\beta}-TCP$. The purpose of this study was to evaluate bone formation following maxillary sinus augmentation using $MBCP^{TM}$ by means of histologic analysis. Material and Method $MBCP^{TM}$ was placed as a primary bone substitute for maxillary sinus augmentation. Three patients were selected after evalaution of their medical dental examination. $MBCP^{TM}$ only, $MBCP^{TM}$ combined with Irradicated cancellous bone and $MBCP^{TM}$ combined with autogenous bone were used for each patient. After about eight months, bone biopsies were harvested for histologic evaluation and fixtures installed. Results Eight months after surgery we observed new vital bone surrounding $MBCP^{TM}$ particle and the amount of new bone was about 30% even though there were discrepancies between specimens. This case report documents that $MBCP^{TM}$ when used as a grafting material for sinus floor augmentation whether combined other bone graft material or not, may lead to the predictable results for dental implants on posterior maxillary area with insufficient vertical height for fixture installation.

• Journal of Periodontal and Implant Science
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• 제40권2호
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• pp.96-101
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• 2010

Purpose: The purpose of this study was to evaluate the effect of collagen matrix with apically positioned flap (APF) on the width of keratinized gingiva, comparing to the results of APF only and APF combined with free gingival graft (FGG) at the second implant surgery. Methods: Nine patients were selected from those who had received treatments at the Department of Periodontics, Chosun University Dental Hospital, Gwangju, Korea. We performed APF, APF combined with FGG, and APF combined with collagen matrix coverage respectively. Clinical evaluation of keratinized gingival was performed by measuring the distance from the gingival crest to the mucogingival junction at the mid-buccal point, using a periodontal probe before and after the surgery. Results: The ratio of an increase was 0.3, 0.6, and 0.6 for the three subjects in the APF cases, 3, 5, and 7 for the three in the APF combined with FGG case, and 1.5, 0.5, and 3 for the three in the APF combined with collagen matrix coverage case. Conclusions: This study suggests that the collagen matrix when used as a soft tissue substitute with the aim of increasing the width of keratinized tissue or mucosa, was as effective and predictable as the FGG.

• Journal of Chest Surgery
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• 제57권1호
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• pp.99-102
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• 2024

This article presents a straightforward hybrid arch technique for treating residual type B aortic dissecting aneurysms following type A repair (replacement of the ascending aorta) that employs a frozen elephant trunk (FET) straight vascular prosthesis. The debranch-first method involves only cutting and sewing the previous ascending graft, inserting the FET from zone 0, and debranching the arch vessels using a trifurcated graft. This technique is less invasive as it eliminates the need to manipulate the dissected distal arch aneurysm. We successfully applied this technique to 3 patients, with no instances of in-hospital death, stroke, or paraplegia. The debranch-first technique, combined with zone-0 FET insertion, simplifies the redo repair of residual type B aortic dissection.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권3호
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• pp.256-262
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• 1998

치조열 환자의 골이식과 관련된 치료계획 수립과 골이식재, 골이식 시기, 교정치료 시기 등 치료방법의 선택에 도움을 주는 자료로 삼고자, 1992년 1월부터 1996년 12월까지 전남대학교병원 구강악안면외과에서 골이식술을 시행한 치조열 환자중 추적검사가 가능한 31명을 대상으로 골이식술과 관련된 여러 가지 항목들과 술후 치조열부의 변연골 높이에 대하여 조사한 결과는 다음과 같다. 성별 분포는 남성(64.5%)이 여성(35.5%)보다 많았고, 남녀성비는 1.8 : 1이었다. 골이식시 연령은 이차 골이식기에 해당하는 6세에서 16세 사이(58.1%)가 많았고, 연령의 범위는 2세부터 33세까지였으며 평균연령은 11세였다. 치조열의 분류에 따른 분포는 편측성(93.5%)이 대부분이었고 그중 좌측(74.2%)이 많았다. 결손치로는 측절치가 많았고 과잉치는 측절치와 견치 사이에서 많이 관찰되었다. 술전 교합상태는 III급 부정교합 및 전치부 교차교합(65.1%)이 가장 많았고, 교정치료는 술전과 술후에 비슷하게 시행되었다. 골이식시 동시 시행한 수술로는 이차 구순수 정술이 가장 많았고, 술후 합병증으로는 골결손이 6례, 구비루가 1례, 열개가 3례 발생되었다. 골이식재로는 PMCB와 DFDB가 사용되었고 술후 변연골의 높이는 PMCB를 이식한 경우에 DFDB를 이식한 경우보다 높았으며, PMCB를 이식한 경우에는 변연골의 높이가 증가되었으나 DFDB에서는 변화가 없었다.

• Journal of Periodontal and Implant Science
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• 제46권4호
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• pp.220-233
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• 2016

Purpose: The aim of this study was to present new a model that allows the study of the bone healing process, with an emphasis on the biological behavior of different graft-to-host interfaces. A standardized "over-inlay" surgical technique combined with a differential histomorphometric analysis is presented in order to optimize the use of critical-size calvarial defects in pre-clinical testing. Methods: Critical-size defects were created into the parietal bone of 8 male Wistar rats. Deproteinized bovine bone (DBBM) blocks were inserted into the defects, so that part of the block was included within the calvarial thickness and part exceeded the calvarial height (an "over-inlay" graft). All animals were sacrificed at 1 or 3 months. Histomorphometric and immunohistochemical evaluation was carried out within distinct regions of interest (ROIs): the areas adjacent to the native bone (BA), the periosteal area (PA) and the central area (CA). Results: The animals healed without complications. Differential morphometry allowed the examination of the tissue composition within distinct regions: the BA presented consistent amounts of new bone formation (NB), which increased over time ($24.53%{\pm}1.26%$ at 1 month; $37.73%{\pm}0.39%$ at 3 months), thus suggesting that this area makes a substantial contribution toward NB. The PA was mainly composed of fibrous tissue ($71.16%{\pm}8.06%$ and $78.30%{\pm}2.67%$, respectively), while the CA showed high amounts of DBBM at both time points ($78.30%{\pm}2.67%$ and $74.68%{\pm}1.07%$, respectively), demonstrating a slow remodeling process. Blood vessels revealed a progressive migration from the interface with native bone toward the central area of the graft. Osterix-positive cells observed at 1 month within the PA suggested that the periosteum was a source of osteoprogenitor elements. Alkaline phosphatase data on matrix deposition confirmed this observation. Conclusions: The present model allowed for a standardized investigation of distinct graft-to-host interfaces both at vertically augmented and inlay-augmented sites, thus possibly limiting the number of animals required for pre-clinical investigations.

• 대한골관절종양학회지
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• 제9권2호
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• pp.139-147
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• 2003

목적: 양성 골종양을 치료하기 위해 골이식 대체물을 이식하였을 때 골 유합을 얻을 수 있는지 여부와 골 이식 대체물 중 황산칼슘(calcium sulfate)과 수산화인회석 (hydroxyapatite)을 이용하여, 골 이식술 후 유합 정도를 비교하여 골 치유 과정에 대한 두가지 골 이식 대체물의 차이점을 보고하고자 한다. 대상 및 방법: 양성 골종양 환자 중 병소의 소파술 시행 후 골 이식 대체물을 이식한 20례를 대상으로 술전후 단순 방사선 소견상 병소 크기, 신생골의 형성, 병소의 재발 여부와 이식 후 조직학적 소견을 관찰하였다. 결과: 총 20례 중 남자가 13례, 여자가 7례였으며 평균 연령은 15.8세(2~5), 술 후 평균 추시 기간은 3년이었다. 방사선 사진상 병소의 면적은 평균 30.7 $cm^3$였으며, 최종 추시상 전체 20례 중 19례에서 성공적인 결과를 보였으며, 1례에서 병소의 재발을 보였다. 나이, 병소 크기와 병변 종류에 따른 차이는 관찰되지 않았다. 결론: 황산칼슘은 생체 적합성이 뛰어나고, 골 전도 작용이 있으며 새로운 골형성에 비례하여 생체내로 흡수되는 특성을 보였고, 이에 반해 수산화인회석은 골 전도 작용이 있지만, 병변의 크기나 주위 환경에 따라 자가골, 자가 골수 이식, 이종골과 병행 사용시 양호한 골치환 결과를 얻을 수 있을 것으로 사료되며, 황산칼슘에 비해 더 느리게 생체내로 흡수되는 결과를 보였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권6호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권5호
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• pp.192-200
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• 2014

Purpose: The objective of this study was to evaluate the interaction between 4-hexylresorcinol (4HR) and antibody as that affects the performance of a silk-4HR combination graft for soft tissue augmentation in an animal model. Methods: The silk graft materials consisted of four types: silk+10% tricalcium phosphate (TCP) (ST0), silk+10% TCP+1% 4HR (ST1), silk+10% TCP+3% 4HR (ST3), and silk+10% TCP+6% 4-HR (ST6). The antibody binding assay tested the 4HR effect and scanning electron microscopic (SEM) exam was done for silk grafts. The animal experiment used a subcutaneous pocket mouse model. The graft - SH0 or SH1 or SH3 or SH6 - was placed in a subcutaneous pocket. The animals were killed at one, two, and four weeks, postoperatively. The specimens were subjected to histological analysis and lysozyme assay. Results: Groups with 4HR applied showed lower antibody binding affinity to antigen compared to groups without 4HR. In the SEM examination, there was no significant difference among groups. Histological examinations revealed many foreign body giant cells in ST0 and ST1 group at four weeks postoperatively. Both ST3 and ST6 groups developed significantly lower levels of giant cell values compared to ST0 and ST1 groups (P < 0.001) at four weeks postoperatively. In the lysozyme assay, the ST1 and ST3 groups showed denser signals than the other groups. Conclusion: 4HR combined silk implants resulted in high levels of vascular and connective tissue regeneration.

• Archives of Plastic Surgery
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• 제41권6호
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• pp.673-678
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• 2014

Background The depth of graft harvest and the residual dermis available for reepithelization primarily influence the healing of split-skin graft donor sites. When the thigh region is chosen, the authors hypothesize based on thickness measurements that the anterolateral region is the optimal donor site. Methods Full-thickness skin specimens were sampled from the anteromedial, anterior, and anterolateral regions of human cadavers. Skin specimens were cut perpendicularly with a custom-made precision apparatus to avoid the overestimation of thickness measurements. The combined epidermal and dermal thicknesses (overall skin thickness) were measured using a digital calliper. The specimens were histologically stained to visualize their basement membrane, and microscopy images were captured. Since the epidermal thickness varies across the specimen, a stereological method was used to eliminate observer bias. Results Epidermal thickness represented 2.5% to 9.9% of the overall skin thickness. There was a significant difference in epidermal thickness from one region to another (P<0.05). The anterolateral thigh region had the most consistent and highest mean epidermal thickness ($60{\pm}3.2{\mu}m$). We observed that overall skin thickness increased laterally from the anteromedial region to the anterior and anterolateral regions of the thigh. The overall skin thickness measured $1,032{\pm}435{\mu}m$ in the anteromedial region compared to $1,220{\pm}257{\mu}m$ in the anterolateral region. Conclusions Based on skin thickness measurements, the anterolateral thigh had the thickest epidermal and dermal layers. We suggest that the anterolateral thigh region is the optimal donor site for split-skin graft harvests from the thigh.

• Journal of Periodontal and Implant Science
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• 제28권2호
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• pp.263-273
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• 1998

For histologic observation of the regenerated bone following guided tissue regeneration (GTR) using ePTFE membranes with calcium carbonate implant and autogenous bone graft, biopsies were collected from 2 patients during 5-year-postoperative surgical reentry. In both combined cases with guided tissue regeneration in conjunction with calcium carbonate implant and autogenous bone graft, significant bone fill and gain in probing attachment level was observed. In histologic examination, specimen in GTR case with calcium carbonate grafting was composed of a dense bone containing vascular channel with lamellar structure and viable bone cells in lacunae, however considerable calcium carbonate particles remained unresorbed and isolated from regenerated bone by the dense cellular and fibrous connective tissue. No formative cells could be seen in contact with remained calcium carbonate particles. In GTR case with autogenous bone grafting, specimen show was composed of a dense lamellar bone containing vascular channel, which showed normal alveolar bone architectures. The present observation indicate that guided tissue regeneration in conjunction with grafting, especially autogenous bone graft, has highly osteogenic potential, however resorbable calcium carbonate granules were not completely resorbed at 5 year postimplantation.