• Title/Summary/Keyword: Maxillofacial defect

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THE RECONSTRUCTION OF THE MAXILLARY WALL DEFECT USING MICRO-TITANIUM MESH (Micro-titanium mesh를 이용한 상악골 결손부의 재건술에 관한 연구)

  • Kim, Seong-Gon;Choi, You-Sung;Choung, Pill-Hoon;Lee, Hee-Chul
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.197-203
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    • 2000
  • Maxillary defect may be induced by trauma, inflammation, cyst, tumor and surgical procedure. In case of limited wall defect, free bone graft has been preferred. But it has some problems such as postoperative bone resorption and soft tissue inclusion to recipient site. And we can not use free bone in the case who has inflammation in the donor site. So we used the micro-titanium mesh as reconstructive material for the maxillary wall defect. We had operated 8 patients who were diagnosed as maxillary partial defects from June 1997 to September 1998 in the Chin-Hae military hospital. They were 1 case of antral wall defect, 1 case of palatal wall defect, 5 cases of infra-orbital wall defects and 1 case of oroantral fistula case. As a result, the micro-titanium mesh has shown the morphological stability and biocompatibility and it could be used in case who has infection. And mesh structure could prevent soft tissue ingrowth to bony defect area. Thus it can be used to the case of maxillary partial defect successfully.

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AN EXPERIMENTAL STUDY ON THE BONE REGENERATION OF TIBIAL BONE DEFECT (경골 이식의 골결손부 골재생에 대한 실험적 연구)

  • Kim, Su-Gwan;Yeo, Hwan-Ho;Kim, Soo-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.275-278
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    • 1998
  • Recently, the clinical applications of the autogenous cancellous bone from the proximal tibial metaphysis show satisfactory results in the repair of maxillofacial bony defect or deformity. The proximal tibia has the potential to yield viable cancellous bone with a minimum of morbidity. The purpose of this study was to investigate the regeneration of a full thickness proximal tibial bone defect with covering or uncovering of cortical bone. The follow-up periods were 4, 8, and 12 weeks. Bone defect of right side was uncovered and left side was covered with cortical bone. In the experimental group (uncovered cortical bone) at 12 weeks, the inside of defect was filled to normal marrow tissue. The cortical bone defect was united of inner, outer callus at 4, 8 weeks in both study group. At 12 weeks, the cortical bone defect was remodeled and invaded by osteoclast (giant cell) in experimental group. In the experimental specimen at 12 weeks, the regenerating tissue of bone defect was not differ from the control group.

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CLINICAL STUDY ON TIBIAL BONE GRAFT (경골이식에 관한 임상 연구)

  • Kim, Sik;Kim, Su-Gwan;Kim, So-Young;Kim, Soo-Min;Park, In-Soon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.540-543
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    • 2000
  • The purpose of this retrospective study was to evaluate the treatment outcome of proximal tibial graft. Thirty-nine patients were grafted with proximal tibia for the repair of maxillofacial defect. Complications can be considered incidental and neglectable clinical significance. It is concluded that the proximal tibial metaphysis offers a promising alternative sources of cancellous bone for the repair of maxillofacial defect.

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Periapical multilocular osteoporotic bone marrow defect

  • Jung Yun-Hoa;Cho Bong-Hae;Nah Kyung-Soo
    • Imaging Science in Dentistry
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    • v.35 no.4
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    • pp.221-223
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    • 2005
  • A case of osteoporotic bone marrow defect, which appeared as a well-defined multilocular radiolucency overlapping the roots of mandibular right second molar, was reported. On periapical radiograph, a daughter cyst-like radiolucency was seen at the anterior margin of the lesion making it difficult to rule out odontogenic keratocyst.

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Reconstruction plates used in the surgery for mandibular discontinuity defect

  • Seol, Guk-Jin;Jeon, Eun-Gyu;Lee, Jong-Sung;Choi, So-Young;Kim, Jin-Wook;Kwon, Tae-Geon;Paeng, Jun-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.6
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    • pp.266-271
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    • 2014
  • Objectives: The purpose of this study was to analyze the survival rate of reconstruction plates that were used to correct mandibular discontinuity defects. Materials and Methods: We analyzed clinical and radiological data of 36 patients. Only discontinuous mandibular defect cases were included in the study. Reconstruction plate survival rate was analyzed according to age, gender, location of defect, defect size, and whether the patient underwent a bone graft procedure, coronoidectomy, and/or postoperative radiation therapy (RT). Results: Plate-related complications developed in 8 patients, 7 of which underwent plate removal. No significant differences were found in plate survival rate according to age, gender, location of defect, defect size, or whether a bone graft procedure was performed. However, there were differences in the plate survival rate that depended on whether the patient underwent coronoidectomy or postoperative RT. In the early stages ($9.25{\pm}5.10months$), plate fracture was the most common complication, but in the later stages ($35.75{\pm}17.00months$), screw loosening was the most common complication. Conclusion: It is important to establish the time-related risk of complications such as plate fracture or screw loosening. Coronoidectomy should be considered in most cases to prevent complications. Postoperative RT can affect the survival rate and hazard rate after a reconstruction plate is fitted.

Reconstruction of an upper lip vermilion defect with a mucosal V-Y advancement flap: a case report

  • Gyu-Jo Shim;Hyun-Woo Yoon;Dohyoung Kim;Tae-Geon Kwon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.4
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    • pp.222-226
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    • 2024
  • The upper lip is a functionally and aesthetically important area of the face. Therefore, reconstruction of an upper lip defect needs sufficient consideration to ensure functional and aesthetic recovery. Several methods, such as wedge resection, rotation flaps, advancement flaps, and myomucosal advancement flaps, have been used to reconstruct vermilion defects. However, it is challenging to reconstruct a vermilion defect because of the possibility of residual asymmetry or scars and restrictions to normal lip movement after the reconstruction. We present the case of a 51-year-old female that had an upper lip vermilion defect caused by a dog bite. The lip defect was reconstructed using a mucosal V-Y advancement flap. This mucosal flap was based on the orbicularis oris muscle with a branch of the superior labial artery to ensure sufficient blood supply. Therefore, flap survival was excellent, and there was no constriction of the flaps. Moreover, the color and contour were matched to the adjacent lip tissue, and re-establishment of the white roll and adequate lip volume were achieved. This mucosal V-Y advancement flap technique represents a reliable method to repair mucosal defects without vascular compromise of the flap.

The use of the buccal fat pad flap for oral reconstruction

  • Kim, Min-Keun;Han, Wonil;Kim, Seong-Gon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.5.1-5.9
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    • 2017
  • Many congenital and acquired defects occur in the maxillofacial area. The buccal fat pad flap (BFP) is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various intraoral defects. In this article, we have reviewed BFP and the associated anatomical background, surgical techniques, and clinical applications. The surgical procedure is simple and has shown a high success rate in various clinical applications (approximately 90%), including the closure of oroantral fistula, correction of congenital defect, treatment of jaw bone necrosis, and reconstruction of tumor defects. The control of etiologic factors, size of defect, anatomical location of defect, and general condition of patient could influence the prognosis after grafting. In conclusion, BFP is a reliable flap that can be applied to various clinical situations.

THE CLINICAL STUDY OF THE MAXILLOFACIAL WAR INJURIES IN KOREAN (한국인 전상환자의 악안면결손에 대한 임상적연구)

  • Choi, Kyu-Hwan;Min, Seung-Ki;Um, In-Woong;Kim, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.4
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    • pp.275-282
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    • 1992
  • Maxillofacial war injures is specific representative of severe hard and soft tissue defect. This type of injuries were different from the trauma because it may be fatal. The purpose of this study was to evaluate the injury type base on the retrograde medical record in the 104 patients from Feb. 1991 to Aug. 1992 in Korea Veterans Hospital. The obtained results were as follows. 1. Among 104 cases, 51 cases(49.0%) were classified as mandibular defects only, and 53 cases (51.0%) were classified as maxillary with mandibular defect (combined). 2. The etiologic factors of injury were gunshot, artillery and grenade or shell: 33 cases, 14cases, and 10 cases respectively in Korea War, 19 cases, 5 cases, and 8 cases respectively in Vietnam War. 3. In 57 cases of mandibular partial defect, the angle area showed the highest frequencies, 18 cases(31.6%). 4. In 42 cases of mandibular segmental defect, the area between the 1st molar and the ascending ramus showed the highest frequencies. 17 cases(40.4%), and almost all cases were unilateral defect (40 cases, 95.0%) 5. Reconstruction method performed for segmental mandibular defect were wire or plate(15 cases, 35.7%) and soft tissue closure only(12 cases, 28.7%), respectively.

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FUNCTIONAL RECONSTRUCTION OF DENTO-PALATAL AND MAXILLARY DEFECT USING STAGED OPERATION OF PREFABRICATED SCAPULAR FREE FLAP AND DENTAL IMPLANTS (분층피부와 분말골로 이식 전 처리된 유리견갑골근피판과 임플란트 보철을 이용한 경구개와 상악골의 기능적 재건)

  • Lee, Jong-Ho;Kim, Myung-Jin;Park, Jong-Chul;Kim, Yung-Soo;Ahn, Kang-Min;Paeng, Jun-Young;Kim, Sung-Min;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Choung, Pill-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.4
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    • pp.301-307
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    • 2004
  • The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

Effect of rhBMP-2 on the healing of bone defect in the low calcium diet rat (rhBMP-2가 저칼슘식이 투여 백서의 골결손부 치유에 미치는 영향)

  • Choi Yong-Suk;Hwang Eui-Hwan;Lee Sang-Rae
    • Imaging Science in Dentistry
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    • v.34 no.1
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    • pp.35-48
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    • 2004
  • Purpose: To investigate the effect of rhBMP-2 on the healing of bone defect in the low calcium diet rat. Materials and Methods: To prepare the experimental model, control group was fed a normal diet and experimental group was fed a low calcium diet for 3 weeks. And then, 4 mm bicortical perforated bone defect was made on mandibular body of each rats. Experimental group was subdivided into two groups; experimental group 1 (rats given a low calcium diet before and after bone defect) and experimental group 2 (rats given a low calcium diet before and after bone defect with rhBMP-2 application). At 1, 3, 5 and 7 weeks after bone defect formation, the rats were terminated. The healing of bone defect was assessed by three-dimensional computerized tomography, soft x-ray radiography, and histopathological examination. Results : The wound healing of the bone defect for control group, experimental group 1, and experimental group 2 showed a increase from 3 weeks after bone defect formation. The experimental group 2 showed a more increase in healing amount than control group and experimental group 1 from 5 weeks after bone defect formation and the experimental group 2 showed a complete recovery of bone defect at 7 weeks after bone defect formation. Conclusion: The healing process of bone defect is accelerated by rhBMP-2 application in the low calcium diet rats.

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