• Title/Summary/Keyword: allografts

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Cryopreserved fascia lata allograft use in surgical facial reanimation: a retrospective study of seven cases

  • Silan, Francesco;Consiglio, Fabio;Dell'Antonia, Francesco;Montagner, Giulia;Trojan, Diletta;Berna, Giorgio
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.2.1-2.6
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    • 2020
  • Background: Facial palsy treatment comprises static and dynamic techniques. Among dynamic techniques, local temporalis transposition represents a reliable solution to achieve facial reanimation. The present study describes a modification of the temporalis tendon transfer using a cryopreserved fascia allograft. Case presentation: Between March 2015 and September 2018, seven patients with facial palsy underwent facial reanimation with temporalis tendon transfer and fascia lata allograft. Patients with long-term palsy were considered, and both physical and social functions were evaluated. The mean follow-up time was 21.5 months. No immediate complications were observed. Patients reported improvement in facial symmetry both in static and dynamic. Improvement was noticed also in articulation, eating, drinking, and saliva control. The Facial Disability Index revealed an improvement both in physical function subscale and in the social/well-being function subscale. Conclusions: This modified orthodromic technique allows to reduce the operative time and the risk of complications connected to the use of autologous tissues. The use of the cryopreserved fascia allografts from cadaveric donors seems to provide promising and long-standing results in the treatment of facial palsy.

Evolving Indication of Meniscal Allograft Transplantation (진화하고 있는 동종 반월연골판 이식술의 적응증)

  • Lee, Bum-Sik;Bin, Seong-Il;Kim, Taehyung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.200-209
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    • 2020
  • The first human meniscal allograft transplantations (MATs) were performed 30 years ago. In the early era, candidates were limited to patients who have favorable joint conditions. MAT is currently indicated for patients with post-meniscectomy symptoms, such as compartmental pain or effusion after a subtotal or total meniscectomy. The current indication for MAT is being expanded to other patients who were not indicated previously. The present article reviews how the indications of MAT have changed over the years.

Complex open elbow fracture-dislocation with severe proximal ulna bone loss: a case report of massive osteochondral allograft surgical treatment

  • Concina, Chiara;Crucil, Marina;Theodorakis, Emmanouil;Saggin, Giorgio;Perin, Silvia;Gherlinzoni, Franco
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.183-188
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    • 2021
  • We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complication-free, massive ulna osteochondral allograft implantation can be considered a valid option in cases of open Monteggia-like lesions associated with ulnar shaft fracture and severe bone loss in active patients, whenever osteosynthesis or joint replacement is not a proper solution. This type of bone stock restoration allows for future surgery, if needed.

Core decompression for early-stage avascular necrosis of the humeral head: current concepts and techniques

  • Michael D. Scheidt;Saleh Aiyash;Dane Salazar;Nickolas Garbis
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.191-204
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    • 2023
  • Avascular necrosis (AVN) of the humeral head is a rare, yet detrimental complication. Left untreated, humeral head AVN frequently progresses to subchondral fracturing and articular collapse. Cases of late-stage humeral head AVN commonly require invasive procedures including humeral head resurfacing, hemiarthroplasty, and total shoulder arthroplasty (TSA) to improve clinical outcomes. However, in cases of early-stage AVN, core decompression of the humeral head is a viable and efficacious short-term treatment option for patients with pre-collapse AVN of the humeral head to improve clinical outcomes and prevent disease progression. Several techniques have been described, however, a percutaneous, arthroscopic-assisted technique may allow for accurate staging and concomitant treatment of intraarticular pathology during surgery, although further long-term clinical studies are necessary to assess its overall outcomes compared with standard techniques. Biologic adjunctive treatments, including synthetic bone grafting, autologous mesenchymal stem cell/bone marrow grafts, and bone allografts are viable options for reducing the progression of AVN to further collapse in the short term, although long-term follow-up with sufficient study power is lacking in current clinical studies. Further long-term outcome studies are required to determine the longevity of core decompression as a conservative measure for early-stage AVN of the humeral head.

The impact of cancer cachexia on gut microbiota composition and short-chain fatty acid metabolism in a murine model

  • Seung Min Jeong;Eun-Ju Jin;Shibo Wei;Ju-Hyeon Bae;Yosep Ji;Yunju Jo;Jee-Heon Jeong;Se Jin Im;Dongryeol Ryu
    • BMB Reports
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    • v.56 no.7
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    • pp.404-409
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    • 2023
  • This study investigates the relationship between cancer cachexia and the gut microbiota, focusing on the influence of cancer on microbial composition. Lewis lung cancer cell allografts were used to induce cachexia in mice, and body and muscle weight changes were monitored. Fecal samples were collected for targeted metabolomic analysis for short chain fatty acids and microbiome analysis. The cachexia group exhibited lower alpha diversity and distinct beta diversity in gut microbiota, compared to the control group. Differential abundance analysis revealed higher Bifidobacterium and Romboutsia, but lower Streptococcus abundance in the cachexia group. Additionally, lower proportions of acetate and butyrate were observed in the cachexia group. The study observed that the impact of cancer cachexia on gut microbiota and their generated metabolites was significant, indicating a host-to-gut microbiota axis.

CLINICAL USAGES OF RAMAL AUTOGENOUS BONE GRAFTS IN DENTAL IMPLANT SURGERY (임플란트 식립 수술시 하악지 자가골이식술의 임상적 활용)

  • Kim, Kyoung-Won;Lee, Eun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.3
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    • pp.266-275
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    • 2008
  • Dental endosseous implants require sufficient alveolar bone volume and quality for complete bone coverage and initial stability. But, atrophy or resorption of alveolar bone height and width according to patient's age and period of tooth loss can prevent ideal implant placement. Bone graft procedure has been proposed before or simultaneously with the placement of dental implants in patients with insufficient alveolar bone volume. While allografts, xenografts, and alloplastic bone grafts have been proposed and studied for alveolar ridge augmentation, the use of autogenous bone grafts represents the 'gold standard' for bone augmentation procedures. Conventional bone grafts are usually harvested from distant sites such as the ilium or ribs. Recently there is a growing use of intraoral bone grafts from intraoral donor sites such as mandibular symphysis, mandibular ramus and maxillary tuberosity. We recommend that the mandibular ramus is a safe autogenous bone graft donor site for bone harvesting with low morbidity. We report various effective autogenous bone graft procedures from mandibular ramus for the implant placement on various atrophic alveolar ridges.

Soft Tissue Augmentation with Silk Composite Graft

  • Park, Yong-Tae;Kweon, Hae Yong;Kim, Seong-Gon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.5
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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.

Techniques for Reparation of Perforations of the Maxillary Sinus Membrane: Article Review (상악동막의 천공 시 처치의 방법)

  • Lim, Hyoung-Sup;Kim, Su-Gwan;Kim, Hak-Kyun;Moon, Seong-Yong;Oh, Ji-Su;Jeon, Woo-Jin;Yun, Dae-Woong;Yang, Seok-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.3
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    • pp.281-285
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    • 2011
  • Sinus floor elevation is a predictable and standard procedure for the treatment of the posterior maxilla before insertion of dental implants. Although overall complication rates are low, complications can occur including sinus membrane perforation, infection of sinus, swelling and hemorrhage. The most common complication is membrane perforation. Recently, various techniques and materials for repair of perforation to the sinus membrane have been proposed. The purpose of this article is to report on various techniques and materials that can be used for repair of perforations to the sinus membrane. The search protocol used was the following electronic database: Pubmed, with a time limit from 1998 to 2009. The key words such as 'sinus lift', 'sinus augmentation', 'sinus floor elevation', 'sinus graft', 'sinus perforation', 'repair of sinus perforation' and 'repair of sinus membrane' were used, alone and in combination, when searching the database. Various techniques have been proposed to manage of perforation of sinus membranes. These include that the use of collagen membranes, demineralized freeze-dried human lamellar bone sheets, processed human allografts, lamella bone, buccal fat pads and suturing. Implant success rate ranges from 69.9% to 98.9%.

Review of Current Facial Allotransplantation and Future Aspects (안면동종이식의 현황고찰과 전망)

  • Seo, Mi Hyun;Lee, Jung A;Oh, Jin Sil;Kim, Soung Min;Myoung, Hoon;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.5
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    • pp.342-351
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    • 2013
  • Advances in immunosuppressive treatments and microsurgical techniques have rendered composite tissues allotransplantation (CTA), such as heteregeneous or non-organ tissues, possible in humans. CTA has evolved dramatically since the first successful rat hind limb allotransplantation. Numerous clinical applications including face, hand, trachea, larynx, and vascularized joint have been performed. Although composite tissue allografts are still in their infancy, they have opened a new era in the field of transplantation surgery and pathology, so that maxillofacial reconstructive surgeons may occasionally be faced with the challenge of diagnosing skin refection of a composite tissue allograft. Facial allotransplantation (FAT) is a new surgical technique that could be considered as a new paradigm in facial reconstruction. Since the first human FAT had been achieved in 2005, 17 cases have been reported in the world up to date. However, many problems such as life-long immunosuppression, immune rejection, ethical problems and psychological problems are remained, so facial CTA is new reconstructive option with no general acceptance. The authors reviewed the indications, the results of 17 cases and their complications, and additional consideration factors in this article, and intended to raise the awareness of oral and maxillofacial surgeons in this type of facial transplantation.

Periodontal healing in intrabony defects treated With demineralized freeze-dried bone allografts in conjunction with ePTFE membranes (DFDBA 와 e-PTFE 차단막 혼합사용이 치주골내낭 치유에 미치는 영향)

  • Kim, Chong-Kwan;Chai, Jung-Kiu;Cho, Kyoo-Sung;Kim, Seong-Hui;Suh, Hye-Yuhn
    • Journal of Periodontal and Implant Science
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    • v.26 no.3
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    • pp.567-577
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    • 1996
  • 탈회냉동건조골 (DFDBA)과 ePTFE막을 사용한 경우와 ePTFE만을 사용한 경우의 조직유도 재생술의 효과를 관찰하였다 . 12명의 환자에서 12개의 골내낭결손부(한 환자당 하나의 결손부)를 통상적인 치주수술 시행한 경우를 대조군(GFS)으로 , 12명의 환자에서 12개의 결손부는 ePTFE(GTR)막 만으로 , 또 다른 환자의 12개결손부는 ePTFE+DFDBA로 시행하였다. 창상안정과 감염방지를 강조한 술후계획이 사용되었다. 술후 6개월째 임상적 치유상태를 평가 하였다. 대조군에서 치주낭깊이, 부착수준, 탐침골깊이, 치은퇴축의 각각의 평균치는 $3.4{\pm}1.3mm$, $2.0{\pm}1.2mm$, $1.3{\pm}2.0mm$, $-1.7{\pm}0.8mm$, GTR 군에서는 $4.3{\pm}l.3mm$, $3.1{\pm}1.5mm$, $4.2{\pm}2.2mm$, $-11{\pm}1.4mm$ 그리고 GTR+DFDBA 군에서는 $3.4{\pm}2.1mm$, $2.4{\pm}1.9mm$, $2.6{\pm}1.6mm$, $-1.2{\pm}1.7mm$를 보였다. 대조군과 GTR+DFDBA 군의 술전 평균 치주낭깊이는 각각 $6.9{\pm}1.1$, $7.4{\pm}1.2$, $7.0{\pm}2.0mm$였다. GTR, GTR+DFDBA군에서는 뚜렸한 치주낭감소와 부착획득을 보였다(P<0.01). GTR, GTR+DFDBA 에서는 대조군에 비해 탐침골수준의 뚜렷한 향상을 보였으나(P<0.001), GTR 과 GTR+DFDBA 사이에는 뚜렷한 차이가 없었다. 이 실험결과로 골내낭 결손부에서 GTR과 GTR+DFDBA의 사용은 골형성을 제외한 임상결과 에서 대조군과 유사한 결과를 보였다.

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