• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권4호
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• pp.329-338
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• 2006

Objectives: Distraction osteogenesis has recently evolved a challenging technique to overcome the limitations of conventional augmentation procedures. The aim of this report was to evaluate the clinical result of alveolar distraction osteogenesis for implant installation. Methods: Twenty five patients with alveolar ridge deficiencies were treated with vertical alveolar distraction osteogenesis by intraoral device (total 27 devices: 25 extraosseous and 2 intraosseous devices). After the latency periods of 5-7 days, activation of the device was started. The distraction rhythm and rate was 0.75-1.0 mm a day with 2 or 3 times a day. After 3-4 months, dental implants were placed with removing the distractor simultaneously. Results: On average, a vertical gain of $9.8{\pm}3.4\;mm$ was obtained by distraction osteogenesis. Total 84 implants were installed. Average follow up period was $13.5{\pm}7.5$ months. No implant was removed during the follow up period. Three patients showed infection during the distraction osteogenesis. Three devices were broken and 2 devices among them were replaced with new one. Conclusion: Relatively larger amount of alveolar bone augmentation could be obtained with distraction osteogenesis. For the ideal anatomically and functionally ideal regeneration of alveolar bone to install dental implant, the complication of distraction should be controlled.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권4호
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• pp.326-329
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• 2002

저자들은 위축된 치조골과 외상 또는 종양으로 상실된 치조골의 재건을 위하여 수직적 치조골 신장술을 이용하여 104명의 환자에서 평균 10.2 mm의 치조골을 신장시킬 수 있었으며, 양호하게 재건된 치조골에 치과 임플란트를 식립함으로서 기능적, 심미적으로 좋은 결과를 얻을 수 있었다. 치조골 신장술은 기존의 치조골 수복술들을 대체할 수 있는 안전하고 효과적인 방법으로 생각된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.154-165
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• 2006

Objectives : It is difficult to place implants at a severely atrophied edentulous mandible because of vertical and horizontal alveolar defect. The autogenous and allogenic bone graft and guided bone regeneration are useful, but there are some limitations such as the resorption and infection of the grafted bone, and insufficiency of soft tissue. Distraction osteogenesis has recently evolved a challenging technique to overcome major draws of conventional augmentation procedures, we, therefore, report the four applications of implant placement after vertical alveolar distraction osteogenesis. Patients and Methods : Four patients(all female, mean age: $60{\pm}6$ years) with severe alveolar ridge deficiencies at their anterior mandible were treated with vertical alveolar distraction osteogenesis by intraoral device(Track 1.5, 15 mm model, KLS Martin, Tuttlingen, Germany) and placement of implants (Branemark MK III, TiUnite). After the latency periods of 5, 7, 8 days, distraction rhythm and rate were $0.5\;mm{\times}2\;times/day$ in the case of good bone quality, and $0.25\;mm{\times}3\;times/day$ in the case of poor bone quality. After consolidation periods of mean fifteen weeks, five implants for each patients were placed at the interforaminal area. Results : On average, a vertical gain of $11.38{\pm}1.38\;mm$ was obtained by distraction. And all distraction zone showed complete ossification by panoramic radiography. There were no postoperative complications other than numbness of lower lip in one case. Total twenty implants in four patients were placed and their outcomes were satisfactory. Conclusion : It is a useful method to place five implants after vertical distraction osteogenesis of the severely atrophied mandible for the implant-supported fixed prosthesis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권5호
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• pp.421-428
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• 2011

Introduction: The purpose of this study was to evaluate the clinical result of vertical alveolar distraction, especially the distracted alveolar bone and installed implants. Materials and Methods: Twenty-one patients who have been received the vertical alveolar distraction and implant installation on 22 areas (3 maxilla and 19 mandible) using intraoral alveolar distraction device were examined. After consolidation period of 3-4 months, distraction devices were removed and 91 implants were installed in the distracted alveolar bone. The distracted bone and implants were evaluated clinically and radiographically. Results: Mean height of distracted alveolar bone was $7.5{\pm}3.2$ mm (range: 2.5-15.0 mm). Mean follow-up period after completion of the distraction was 3.1 years (range: 1.4-11.5 years). Mean resorption of distracted alveolar bone was $1.6{\pm}1.8$ mm. The success and survival rates of implants was 95.3% and 100%, respectively. Conclusion: Results of this study indicate that vertical alveolar distraction procedure is a useful and stable method for alveolar ridge augmentation and implantation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.539-544
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• 2011

Maxillary canting and vertical shortening of the unilateral mandibular ramus height is common in cases of severe facial asymmetry. Normally, mandibular distraction osteogenesis (DO) with horizontal osteotomy at the ascending ramus is used for vertical lengthening of the mandibular ramus to correct facial asymmetry with an absolute shortened ascending ramus. In this case report, vertical lengthening of the ascending ramus was performed successfully with unilateral DO and sagittal split ramus osteotomy (SSRO), where the posterior part of the distal segment can be distracted simultaneously in an inferior direction with maxillary DO, resulting in a lengthening of the medial pterygoid muscle. This case describes the acquired unilateral mandibular hypoplasia caused by a condylar fracture at an early age, which resulted in abnormal mandibular development that ultimately caused severe facial trismus. The treatment of this case included two-stage surgery consisting of bimaxillary distraction osteogenesis for gradual lengthening of the unilateral facial height followed by secondary orthognathic surgery to correct the transverse asymmetry. At the one year follow-up after SSRO, the vertical length was maintained without complications.

• 대한구순구개열학회지
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• 제8권1호
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• pp.11-22
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• 2005

상악골의 열성장과 횡적 부조화, 그리고 광범위한 치조열 및 구강상악동 누공의 치료에 있어서 기존의 방법에 비해 골신장술을 사용하였을 경우, 본 증례들과 관련 문헌 고찰을 통하여, 견인량의 충분한 확보 및 회귀율의 최소화를 얻을 수 있으며, 또한 입원가료기간의 감소와 연조직 부조화의 해결을 볼 수 있어 구순구개열에 관련된 상악골 변형의 치료에 골신장술이 유용한 치료법이라 생각되어 보고한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.32.1-32.8
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• 2018

Background: The free vascularized fibula flap presents many advantages such as sufficient length of the bony segment, good vascularization, better quality of the bone, and a long vascular pedicle, but it is also associated with some disadvantages with regard to prosthetic rehabilitation because of its limited height. Improvement in bone height is necessary for ideal dental implant treatment of reconstructed mandibles. Case presentation: For two squamous cell carcinoma patients, mandibular bone reconstruction was performed secondarily with the peroneal flap after tumor resection. Since the bone height was insufficient at the time of implant treatment, occlusion reconstruction by dental implant was performed after vertical distraction osteogenesis. Conclusions: Vertical distraction osteogenesis is a suitable treatment option for alveolar ridge deficiency resulting from fibula transplantation for mandibular reconstruction following tumor surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권4호
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• pp.312-321
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• 2007

Purpose: Distraction osteogenesis has been applied to the maxillofacial implantology and good experimental and clinical results have been reported. However, histologic studies of implants placement on distraction osteogenesis of atrophic alveolar ridges are scarce. In this study, we compare the bone formation between in the transport part and in the distraction part by histomorphometric analysis. Materials & methods: Three adult beagle dogs were served as experimental subjects. The 2 premolars and 1st molar were extracted on the Lt. side of mandible in each beagle dog. After one month later, osteotomy was performed and distraction device was adapted. Distraction was performed with gradual incremental separation of two bone pieces at a rate of 1.0mm per day for 5 days. During consolidation phase, new bone was formed in the distraction zone between the separated bone pieces. 5 weeks after distraction phase, 3 implants were placed in each beagle dog. The implants were inserted through transport part and distraction part and inferior basal bone. The animals were sacrificed at 2 weeks, 4 weeks, and 12 weeks after implant placement. BIC and BA of implants on distraction part and transport part were measured histomorphometrically. Results: BIC, BA increased after implant placement as time goes by passes and new bone formation was slightly higher in transport part than in distraction part at 2 weeks, 4 weeks after implant placement. At 12 weeks after implant placement, BIC, BA of were 74%, 61% in transport part and 77%, 59% in distraction part, therefore there were no difference in BIC and BA between transport part and distraction part at 12 weeks after implant placement.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권2호
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• pp.123-131
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• 2007

Introduction: Distraction osteogenesis is widely used as for bone lengthening in patients with maxillofacial deformity and alveolar bone atrophy. One of the major problems in distraction osteogenesis is long consolidation period for 2-3 months, in which the devices have to be fixed on the bone to prevent relapse. It results in scar formation on the face, disturbance of mastication and speech. This study was performed to evaluate the stimulating effect of pulsed electromagnetic field on the early bone consolidation in distraction osteogenesis. Materials and methods: Total 10 rabbit were used (5 for control group, 5 for experimental group). A vertical osteotomy in the mandibular body was performed and the distraction device was fixed. After 5 days distraction was done 1mm per a day for 7 days. A pulsed electromagnetic field (38 Gauss, 60 Hz) was applied for 8 hours per day and it continued for 5 days immediately after distraction in the experimental group. Both groups were sacrificed after 2 weeks. Histological specimens with H&E and Masson Trichrome staining were made and histomorphometrically analysed with image analyser. Results: The device for distraction osteogenesis was displaced in one animal for each group, therefore, only four animals in both groups were evaluated. In both groups, a new bone formation was observed in the distracted area after 2 weeks. The bone formation was enhanced in the experimental groups ($31.76{\pm}8.68%$) compared with control group ($9.94{\pm}3.23%$), its difference was statistically significant (p<0.001). Conclusion: This study suggests that electrical stimulation with electromagnectic field may be effective in the early bone formation after distraction osteogenesis. Further studies with large number of animals are needed before clinical application.

• 한국임상수의학회지
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• 제19권2호
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• pp.165-173
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• 2002

The purpose of this study was to evaluate the effect of chitosan-calcium sulfate mixture on early bony consolidation in osteodistracted dogs. The experimental group was divided into 3 groups: saline group(Control), chitosan group(Group CH) and chitosan-calcium sulfate mixture group(Group CH+CS). Four dogs were allocated to each group and classified into B week observation subgroups and 5 week observation subgroups, respectively. Two dogs were allocated to each subgroup. The lateral surface of the left mandibular body was exposed in the subperiosteal plane and vertical osteotomy was carried out on the mandibular body. An external distraction device was applied to the mandibular body. Mandibular distraction was started 5 days after the osteotomy at a rate of 1 m per day for a total of 10 w distraction for 10 days. After completion of distraction, chitosan, chitosan-calcium sulfate and saline were injected into the distracted zone of the group CH, group CH+CS and control. The external device was left in place for 3 or 5 weeks to allow for bony consolidation. Serial radiographs were carried out every week. Two dogs of each group, six dogs in total, were sacrificed at 3 weeks, and the other six dogs at 5 week after distraction. Bone specimens of the distracted mandibles were taken for histologic examination. New bone was not noted in the distracted zone of 3 week observation subgroups in the control and group CH. However, new bone was developed in the group CH+CS with a narrow fibrous interzone in the area of the distracted zone. While osteogenesis was mild in the margin of the distracted Bone of 5 week observation subgroup in the control, new bone was noted much in the group CH and group CH+CS. However, osteogenesis was noted more significantly in the group CH+CS than that of group CH. In conclusion, chitosan-calcium sulfate mixture was more effective on early bony consolidation in distraction osteogenesis