• Title/Summary/Keyword: Soft tissue augmentation

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TISSUE REACTION IN RESPONSE TO AUGMENTATION OF SOFT TISSUE DEFECTS ACCORDING TO THE DERMIS GRAFT MATERIALS IN RABBITS (연조직 결손을 일으킨 가토에서 진피 이식재에 따른 조직반응 비교)

  • Ha, Hyun;Kim, Sun-Kook;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.114-120
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    • 2007
  • The augmentation of soft tissue defects is one of the critical problems in the oral and maxillofacial surgery. Various types of graft materials, both autologous and non-autologous, have been used for the augmentation of soft tissue in the facial region. However, it is not easy to choose an ideal material for soft tissue augmentation because each has its advantages and disadvantages. An ideal graft material should meet the following criteria : it should not leave a scar at the area from which it was taken; should have less likelihood of causing infection; should feel natural after implanted; and should be not absorbed. Among the materials meeting these criteria, human dermis and artificial dermis are commonly used for clinical purposes. The present study was aimed to investigate and compare the resorption rate and the histological change following the use of the autologous dermis, the human homogenous dermis $Alloderm^{(R)}$, and the artificial dermis $Terudermis^{(R)}$ to reconstruct the soft tissue defect. Twenty mature rabbits of either sex, weighing about 2 ㎏, were used. Each rabbit was transplanted with the autologous dermis, $Alloderm^{(R)}$, and $Terudermis^{(R)}$ size $1{\times}1-cm$ at the space between the external abdominal oblique muscle and the external abdominal oblique fascia. They were then divided into 4 groups (n=5 each) according to the time elapsed after the surgery: 1, 2, 4, and 8 weeks. The resorption rate was calculated by measuring the volume change before and after the transplantation, and H-E stain was preformed to observe the histological changes. The resorption rate after 8 weeks was 21.5% for the autologous dermis, 16.0% $Alloderm^{(R)}$, and 36.4% $Terudermis^{(R)}$, suggesting that $Alloderm^{(R)}$ is the most stable while $Terudermis^{(R)}$ is the most unstable. In microscopic examinations, the autologous dermis graft was surrounded by inflammatory cells and showed foreign body reactions. The epidermal inclusion cyst was observed in the autologous dermis graft. $Terudermis^{(R)}$ and $Alloderm^{(R)}$ demonstrated neovascularization and the progressive growth of new fibroblast. The results suggest that $Terudermis^{(R)}$ and $Alloderm^{(R)}$ can be availably for substituting the autologous dermis.

The Effective Utilization of GBR and VIP-CT(Vascularized Interpositional Periosteal Connective Tissue) graft in the Anterior Maxillary Immediate Implantation : A Clinical Case Report (상악 전치부 발치 즉시 식립시 골유도재생술과 혈관개재 골막-결합조직 판막술(VIP-CT graft)의 활용)

  • Lim, Pil
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.28 no.2
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    • pp.74-85
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    • 2019
  • The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. A newer technique, VIP-CT (Vacularized Interpositional Periosteal Connective Tissue) graft has been introduced as an alternative to these technique which allows the clinicians perform large volume soft tissue augmentation in esthetic sites with a single procedure. The advantages of the VIP-CT graft technique are that it allows the reconstruction of large soft tissue deficiency, with little constriction postoperatively. Furthermore, it facilitates improved hard tissue augmentation due to the additional blood supply and improved bone healing by mesenchymal cells. Moreover, this technique reduces patient discomfort and treatment time. This clinical report describes the procedure of bone augmentation during immediate implantation in facial dehiscence defect, especially Vascularized Interpositional Periosteal Connective Tissue(VIP-CT) graft for aesthetic anterior soft tissue.

Effects of soft tissue stretching using negative pressure on women's breast augmentation (음압원리를 이용한 연부조직 스트레칭이 여성의 유방 확대에 미치는 영향)

  • Kim, Kyung-Yun;Lee, Eun-Ju
    • Journal of the Korea Convergence Society
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    • v.11 no.1
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    • pp.285-291
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    • 2020
  • There is a growing interest in breast augmentation surgery, which can most effectively maximize femininity, among modern women around the world. However, breast augmentation surgery is considered one of the most terrifying surgeries many women are afraid of, as many cases of its side effects have been reported. As a way to provide a complementary method to deal with it, this study investigated the effects of a non-surgical breast enhancement program by stretching soft tissue of the breast. According to the results, there was no change in body weight and breast elasticity, but there were marked increases in breast cup size, breast diameter and volume of the women who used this program. The external soft tissue expansion system was found to be effective in Korean women's change of breast shape. On the other hand, users should use this system regularly for some period of time, and this would limit their social activities. Therefore, for the effective use of this system, its users should make individual efforts.

Immediate implant placement in conjunction with guided bone regeneration and/or connective tissue grafts: an experimental study in canines

  • Lim, Hyun-Chang;Paeng, Kyeong-Won;Kim, Myong Ji;Jung, Ronald E.;Hammerle, Christoph HF.;Jung, Ui-Won;Thoma, Daniel S.
    • Journal of Periodontal and Implant Science
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    • v.52 no.2
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    • pp.170-180
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    • 2022
  • Purpose: This study was conducted to assess the effect of hard and/or soft tissue grafting on immediate implants in a preclinical model. Methods: In 5 mongrel dogs, the distal roots of P2 and P3 were extracted from the maxilla (4 sites in each animal), and immediate implant placement was performed. Each site was randomly assigned to 1 of the following 4 groups: i) gap filling with guided bone regeneration (the GBR group), ii) subepithelial connective tissue grafting (the SCTG group), iii) GBR and SCTG (the GBR/SCTG group), and iv) no further treatment (control). Non-submerged healing was provided for 4 months. Histological and histomorphometric analyses were performed. Results: Peri-implant tissue height and thickness favored the SCTG group (height of periimplant mucosa: 1.14 mm; tissue thickness at the implant shoulder and ±1 mm from the shoulder: 1.14 mm, 0.78 mm, and 1.57 mm, respectively; median value) over the other groups. Bone grafting was not effective at the level of the implant shoulder and on the coronal level of the shoulder. In addition, simultaneous soft and hard tissue augmentation (the GBR/SCTG group) led to a less favorable tissue contour compared to GBR or SCTG alone (height of periimplant mucosa: 3.06 mm; thickness of peri-implant mucosa at the implant shoulder and ±1 mm from the shoulder: 0.72 mm, 0.3 mm, and 1.09 mm, respectively). Conclusion: SCTG tended to have positive effects on the thickness and height of the periimplant mucosa in immediate implant placement. However, simultaneous soft and hard tissue augmentation might not allow a satisfactory tissue contour in cases where the relationship between implant position and neighboring bone housing is unfavorable.

Three key factors for successful esthetic anterior implant restoration (성공적인 전치부 심미 임플란트를 위한 3가지 요소)

  • Lim, Pil
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.25 no.1
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    • pp.35-49
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    • 2016
  • With the increasing demand for aesthetic implant dentistry, the importance of implant restoration is emphasized not only in the functional aspect but also in the aesthetic aspect. The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. The soft tissue aesthetics are dependent upon the condition of the supporting hard tissue because the osseous structure provides a framework for the development of a healthy and aesthetic soft tissue interface. Therefore, the augmentation of hard tissue is a first step and especially, optimal 3-dimensional position of implant is the most important factor in aesthetic implant restoration. The management of soft tissue is a second step, and the final step is a restoration of harmonic prosthesis using provisional restoration with proper emergence profile. This clinical report describes the procedure of bone augmentation in labial dehiscence defect, Vascularized Interpositional Periosteal-Connective Tissue (VIP-CT) flap for aesthetic anterior soft tissue, and the importance of provisional restoration and impression taking stage with customized impression coping.

Clinical Experiences with the Scapular Fascial Free Flap

  • Park, Il Ho;Chung, Chul Hoon;Chang, Yong Joon;Kim, Jae Hyun
    • Archives of Plastic Surgery
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    • v.43 no.5
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    • pp.438-445
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    • 2016
  • Background The goal of reconstruction is to provide coverage of exposed vital structures with well-vascularized tissue for optimal restoration of form and function. Here, we present our clinical experience with the use of the scapular fascial free flap to correct facial asymmetry and to reconstruct soft tissue defects of the extremities. Methods We used a scapular fascial free flap in 12 cases for soft tissue coverage of the extremities or facial soft tissue augmentation. Results The flaps ranged in size from $3{\times}12$ to $13{\times}23$ cm. No cases of total loss of the flap occurred. Partial loss of the flap occurred in 1 patient, who was treated with a turnover flap using the adjacent scapular fascial flap and a skin graft. Partial loss of the skin graft occurred in 4 patients due to infection or hematoma beneath the graft, and these patients underwent another skin graft. Four cases of seroma at the donor site occurred, and these cases were treated with conservative management or capsulectomy and quilting sutures. Conclusions The scapular fascial free flap has many advantages, including a durable surface for restoration of form and contours, a large size with a constant pedicle, adequate surface for tendon gliding, and minimal donor-site scarring. We conclude that despite the occurrence of a small number of complications, the scapular fascial free flap should be considered to be a viable option for soft tissue coverage of the extremities and facial soft tissue augmentation.

Maxillary tuberosity connective tissue graft for restoration of gingival depression in the anterior implant region (전치부 임플란트 영역 치은 함몰 회복을 위한 결체조직 이식술에서 상악결절 수여부의 선택)

  • Lee, Dong-Woon;Jung, Gwang-Young;Bang, Joo-Hyuk;Lee, Keun-Woo
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.30 no.2
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    • pp.102-111
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    • 2021
  • Implant placement in the anterior region is performed in several stages, and harmonization of both hard and soft tissues is essential. In addition, adequate esthetic and functional evaluations are necessary in the process of transitioning from the provisional to the final prosthesis to attain patient satisfaction. Although gingiva can be molded in the anterior region, depression in the occlusal view can yield good results through the augmentation procedure. However, the harvesting of connective tissue from the palate is not suitable for various reasons, such as postoperative discomfort and intraoperative bleeding. Compared to the palatal area, the harvesting of connective tissue from the maxillary tuberosity can easily result in relatively thick tissue and quick healing of the donor site, thus proving to be a good modality for graft procedures. The purpose of this report is to examine the relevant evidence from previous studies and evaluate the process of soft tissue augmentation through a case presentation.

Regeneration of total tissue using alveolar ridge augmentation with soft tissue substitute on periodontally compromised extraction sites: case report (치주질환 원인의 심한 골소실을 동반한 발치와에 대한 치조제 증강술과 연조직 대체제를 이용한 조직 재생 효과: 증례보고)

  • Yerim Oh;Jae-Kwan Lee;Heung-Sik Um;Beom-Seok Chang;Jong-bin Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.276-284
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    • 2023
  • After tooth extraction, alveolar bone is resorbed over time. Loss of alveolar bone and reduction of upper soft tissue poses difficulties in future implant placement and long-term survival of the implant. This case report focuses on increasing the soft and hard tissues at the implant placement site by using alveolar ridge augmentation and a xenogeneic collagen matrix as a soft tissue substitute in an extraction socket affected by periodontal disease. In each case, the width of the alveolar bone increased to 6 mm, 8 mm, and 4 mm, and regeneration of the interdental papilla around the implant was shown, as well as buccal keratinized gingiva of 4 mm, 6 mm, and 4 mm, respectively. Enlarged alveolar bone facilitates implant surgery, and interdental papillae and keratinized gingiva enable aesthetic prosthesis. This study performed alveolar ridge augmentation on patients with extraction sockets affected by periodontal disease and additionally used soft tissue substitutes to provide a better environment for implant placement and have positive effects for aesthetic and predictive implant surgery.