• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.255-263
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• 2009

Purpose: An osseous defect in the glenoid and humeral head is closely associated with recurrence of anterior shoulder instability. The purpose of this article is to describe the open surgical techniques and introduce our experiences with anterior instability with a significant osseous defect. Materials and Methods: We reviewed the articles that have focused on and/or mentioned the affect of osseous defects on anterior shoulder instability. The open surgical techniques and its related pearls are summarized in this review. Results: Accurate evaluation for the size and location of the osseous defect is critical for preventing recurrence after restoration of the anterior capsulolabral structure. The glenoid bone restoration techniques include the coracoids transfer (the Bristow procedure and the Latarjet procedure) and a structural iliac bone graft. Rotational humeral osteotomy and an osteoarticular allograft could be used for repairing a significant posterosuperior humeral defect (Hill-Sachs lesion). Shoulder arthroplasty may be tried for treating a humeral bone defect, but more study on this is needed. Conclusion: Open surgical restoration decreases the risk of recurrence anterior shoulder instability that is combined with a significant osseous defect. Arthroscopic surgery currently has limitations for treating an osseous defect, but it will become useful in proportion to the development of arthroscopic instruments and techniques in the future.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.75-80
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• 2001

Purpose : We have evaluated the morbidity of donor site after transfer of free fibular osseous and osteocutaneous flap to defect site of bone and soft tissue due to chronic osteomyelitis of long tubular bone, open fracture with bony defect, bone or soft tissue tumor and congenital anomaly. Materials and methods : The 54 cases of 79 cases to be carried out from May, 1982 to May, 2001 which could be followed up were reviewed. There were forty nine in male and five in female. The mean age was 35(4 to 66)years old and mean follow up period is 21.3 month(12 to 72). We have retrospectively analyzed the various postoperative complications such as compartment syndrome, donor site infection, skin defect, hypesthesia, hammer toes, ankle instability and activity of daily living by help of questionnaire, telephone, physical examination, follow up x-ray study and chart. Results : In the total 54 cases the medication period for pain control after operation were classified into three groups under 2 weeks(49 cases), from 2 weeks to 6 weeks(3 cases) and over 6 weeks(2 cases). The postoperative morbidity were occurred in total 12 cases(compartment syndrome: 0, infection : 2, skin defect: 1, hypesthesia: 5, hammer toe: 2 ankle pain: 2 discomfort in activity of daily living: 0), and also the morbidity rates of donor site were 23.5% in osseous flap and 21.6% in osteocutaneous flap were occurred. There was no statistical significonce in morbidity between osseous and osteocutaneous free fibular flap transfer(P>0.05). Discussion : In general the morbidity of free fibular flap transfer was relatively high but it did not have any effect on daily activity of living. We think that the meticulous operation technique, detailed wound care and early range of motion exercise will reduce the morbidity of donor site of flap.

• Imaging Science in Dentistry
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• v.46 no.2
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• pp.141-144
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• 2016

The aim of this report is to present two cases of canalis basilaris medianus as identified on cone-beam computed tomography (CBCT) in the base of the skull. The CBCT data sets were sent for radiographic consultation. In both cases, multi-planar views revealed an osseous defect in the base of the skull in the clivus region, the sagittal view showed a unilateral, well-defined, non-corticated, track-like low-attenuation osseous defect in the clivus. The appearance of the defect was highly reminiscent of a fracture of the clivus. The borders of osseous defect were smooth, and no other radiographic signs suggestive of osteolytic destructive processes were noted. Based on the overall radiographic examination, a radiographic impression of canalis basilaris medianus was made. Canalis basilaris medianus is a rare anatomical variant and is generally observed on the clivus. Due to its potential association with meningitis, it should be recognized and reported to avoid potential complications.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.737-744
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• 2008

Purpose: In advanced case of periodontitis, surgical treatment without bone contouring may result in residual pockets inaccessible to proper cleaning during post-treatment maintenance. This problem can be avoided or reduced by applying guided tissue regeneration. Materials and Methods: All of 3 patients had deep periodontal pocket depth and bleeding on probing, and radiograph revealed osseous defect, so we planned guided tissue regeneration using resorbable membrane with or without xenograft. Result: 6 months later, periodontal pocket depth and bleeding on probing was improved and gingiva was stable. Conclusion: Guided tissue regeneration using resorbable membrane with or without xenograft in osseous defect is predictable.

• Journal of Periodontal and Implant Science
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• v.23 no.2
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• pp.345-351
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• 1993

Various alloplastic materials have been used on the periodontally diseased ossous defects. Hydroxyapatite, which is used the most common alloplastic material is a non-resorbable form of calcium phosphate and natural coral which is a biodegradable by carbonic anhydrase in osteoclast was introduced recently. The purpose of the present study was to evaluate the clinical effects of porous hydoxyapatite and natural coral on the human periodontal defects. Four males and three females who had adult periodontitis were selected for this study. The teeth that had similar bone loss radiographically and periodontal pocket deeper than 5mm were selected. Gingival recession, pocket depth, plaque index(Silness & Loe), sulcus bleeding index and tooth mobility (measured by Periotest$^{(r)}$) were examined before graft. Before insertion of alloplastic materials, the depth from CEJ to bone crest and from CEJ to base of the osseous defect was recorded. Porous particulate hydroxyapatite(Interpore 200$^{(r)}$, A group) was place on the defect and natural coral(Biocoral$^{(r)}$, B group) was placed on the defect of the opposing tooth. Six months post-surgically the same parameters were recorded by reentry procedures. A and B group showed 0.6mm of mean recession. Mean reduction of pocket depth were 5mm for A group and 4.9mm of B group. Reduced SBI and tooth mobility were recorded. Osseous defect fills of the original defects were 2.9mm for A and 3mm for B group. Percentage defect fills were 71% for A and 59% for B group. The difference of defect fill between pre- and post-insertion was statstically significant(p<0.05). But the difference between the two groups was not significant statistically(p<0.05). The clinical impression at 6 month re-entry and the numerical date indicate that natural coral as well as porous particulate hydoxyapatite has a definite potential as an alloplastic implant in the treatment of periodontal osseous defects.

• The Journal of the Korean dental association
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• v.47 no.8
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• pp.498-504
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• 2009

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.10 no.1
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• pp.63-68
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• 1980

The purpose of this article is to re-examine the roentgenographic appearance of alveolar osseous in an effort to determine the value of the orthopantomogram in the diagnosis of periodontal disease. A total of 158 osseous lesions from 13 human dry skulls were studied. 14 Ultra-speed periapical films, 2 bitewing films and Kodak panoramic film are used to obtain radiographs of all defects. The bisecting technic was used, with a target-film distance of. 8 inches and exposure factors of 70 kVp, 10MA and 0.4 sec. at anterior teeth, 0.6 see at posterior teeth in exposure time. For orthopantomogram, Panoura Eight-C was used with a exposure factors of 90kVp, 10MA. and 15sec. exposure time. All films were developed in a light. tight darkroom at 68°F for 4½ minutes. Comparison of orthopantomogram and intraoral films on the view-box was carefully studied in relation to the types of osseous defect visually evident; Proximal intraosseous defects, Interproximal craters, Interproximal hemisepta, Furcal defects on multirooted teeth, and Facial or Lingual one-walled defects. The results obtained were as follows; 1. Proximal osseous defects throughout the dental arches and furcal defects on facial and lingual surfaces of multirooted teeth can be identified with a high degree of accuracy from their orthopantomographic appearances. 2. Lesions on facial or lingual surface of the alveolar arches are rather difficult to locate or recognize on the dental radiographs. 3. In determining whether the proximal and furcal lesions are located facially or lingually, Orthopantomogram is superior to the conventional film Orthopantomogram obtained with standardization of head in proper position revealed the complete visualization of alveolar bone without showing occlusal surface of molars and proximal superimposition of teeth. Thus, on the standardized orthopantomograms, The roentgenographic characteristics of each defect were determined.

• Imaging Science in Dentistry
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• v.34 no.3
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• pp.171-174
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• 2004

The present study reports a case of developmental salivary gland defect. On panoramic examination, large radiolucent lesion surrounded by a sclerotic wall was noted in the right posterior mandible. On CT examination, large lingual bone concavity with extra-osseous course of the inferior alveolar nerve bundle was detected. In atypical cases, it is suggested that confirmatory imaging using CT or MRI should be taken.

• Archives of Reconstructive Microsurgery
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• v.13 no.2
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• pp.93-100
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• 2004

This study was designed to investigate the optimal period of pedicles implantation in the prefabricated periosteofascial flap with a vascular tissue transfer. The flap prefabrication was prepared with a transposition of left occipital pedicles on the calvarial fascia of male Sprague-Dawley rats. Thirty flaps were divided into five groups of six flaps, including control group (group I) of the conventional periosteofascial flap based on the lateral border of the rat calvarium. The prefabricated flap was elevated as an $1{\times}1cm$ sized island flap based on the implanted pedicle at 1, 2, 3, and 4 weeks after the pedicles transfer in groups II, III, IV, and V, respectively. After the completion of creating a critical-sized calvarial defect and implanting with hydroxyapatite granules, the flap was sutured back for covering the defect and kept isolated from surrounding tissues. Six weeks after flap repositioning, the osseous changes of the defect were examined with simple radiographic findings, radiodensitometric analysis, and histological studies. By simple radiographic findings, specimens of the control, groups IV and V showed homogeneous radioopacity within the defect. But in groups II and III, focal radiolucency was observed in the defect. In the radiodensitometric analysis, the control group and the group V showed significant increased radiodensites statistically. Histologically, the implanted hydroxyapatite was absorbed partly in the defect in groups II, III, and IV. In the defects of the control group and the group V, the implanted hydroxyapatite was kept in its volume and the deposition of the bone cells was observed sparsely. In conclusion, the prefabricated periosteofascial flap can be created with a vascular tissue transfer and the pedicles should be implanted at least for 4 weeks to bring out positive osseous changes in the calvarial defect.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.2
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• pp.269-278
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• 1996

To overcome the limitations of conventional microsurgical tissue transfer, experimental creation of various neo-flaps using the vessel implantation technique has been reported. We have performed some experiments of fabrication of neo-osseous flap with local vessels and iliac bone slabs to know that the flap vascularity and neo-angiogenesis are achieved enough to microtransfer. As a next step of our previous experiments, the flap viability and the histologic change between the recipient bone and neo-oseous flap was assessed after microsurgical transplantation. The flap was created on the rabbit femoral region(n=25) using femoral vessel and the iliac bone segments($2.5{\times}1.5cm$ in size). Three weeks after neovascularization, the newly formed flap was harvested and microtransferred to the mandibular defect. As a control, contralateral mandibular defect was created and reconstructed with conventional free iliac bone graft. Scintigrams of experimental group performed 3 days after microtransfer showed hot uptake, while that of control poor uptake. Histologic and vital stain labeling study revealed good bone viability and vascularity of neo-osseous flap. In conclusion, prefabricated neo-osseous flap of our model could be transferred to the recipient site with retaining the flap viability and showed advantages over the conventional bone graft in that it was living bone graft.