• The Journal of the Korean bone and joint tumor society
• /
• v.10 no.1
• /
• pp.1-12
• /
• 2004

Purpose: The current study was performed to analyze the oncological and functional results, and the patient, the limb and the prosthesis survival of osteosarcoma around the knee in children according to the treatment options. Materials and Methods: From 1982 to 2002, 63 patients with osteosarcoma around the knee underwent surgical treatments before 16 years of age. Surgical treatment options were amputation, endoprosthetic replacement, and implantation of low heat-treated autogenous bone graft after wide resection of tumor. The mean age of patients was 11.5 years (4.4~16), and the mean follow-up period was 6.1 years (2.1~16.8). All patients had neoadjuvant and adjuvant chemotherapy. All endoprosthses were extendible types. Anatomical locations of osteosarcoma were distal femur in 40 patients, and proximal tibia in 23 patients. As regard to Enneking stage, 4 patients had stage $II_A$, 50 patients had stage $II_B$, and 9 patients had stage III tumors. Results: The 5 year survival rate of stage $II_B$ patients was 72.7% in amputation, 83.7% in endoprosthesis, and 100% in low heat-treated autogenous bone graft. The 5 year survival rate of salvaged limb was 84.4% in endoprosthesis, and 80% in low heat-treated autogenous bone graft. The survival rate of prosthesis was 92.7% at 5 years, 67.4% at 10 years in endoprosthesis, and 75% at 5 years in low heat-treated autogenous bone graft. Mean functional outcome scores were 8.7 points in amputation, 20.6 points in endoprosthesis, and 16 points in low heat-treated autogenous bone graft. Distant metastasis occurred 15.8% in amputation, 27% in endoprosthesis and local recurrence occurred 8.1% in endoprosthesis, 14.3% in low heat-treated autogenous bone graft. Major complications happened 26.3% in amputation, 35.1% in endoprosthesis, and 28.6% in low heat-treated autogenous bone graft. Conclusion: Limb salvage procedure had functionally better results than amputation in children with osteosarcoma around the knee. Reconstruction with endoprosthesis after resection of tumor had good results in children as adults. In certain circumstances as too small bone for endoprosthesis or minimal bony destruction or too skeletally immature patient, low heat-treated autogenous bone graft may be a good treatment option. Low heat-treated autogenous bone graft may be considered as not only a substitute for endoprosthesis but also a temporary method before endoprosthesis.

• The Journal of the Korean bone and joint tumor society
• /
• v.1 no.2
• /
• pp.189-193
• /
• 1995

The authors reviewed 49 cases(48 patients) of benign bone tumor who had surgical treatment with xenograft at department of orthopedic surgery, Seoul National University Hospital from May, 1980 to May, 1994. Materials consist of 21 males and 27 females. The mean age at operation was 20.1 years(range : 4 -55 years) and the mean follow up period was 25.4 months(range : 7 - 85 months). We did xenograft only in 34 cases and xenograft mixed with autograft in 15 cases(14 cases, from ilium, 1 case from femur). The used materials for xenograft were $Lubboc^{(R)}$ in 29 cases, $Surgibone^{(R)}$ in 17 cases and $Pyrost^{(R)}$ in 3 cases. The average durations when bony union was achieved in radiograph were 13.8 weeks in whole cases, 12.5 weeks(range : 8 - 24 weeks) in $Lubboc^{(R)}$ graft cases and 15.7 weeks(range : 6 - 24 weeks) in $Surgibone^{(R)}$ graft cases. The tumor recurred in 4 cases, 1 case was recurred giant cell tumor at distal femur treated with mixed auto and $Lubboc^{(R)}$ graft and 2 cases were large cystic lesions at the proximal humerus diagnosed as simple bone cyst and at distal tibia diagnosed as fibrous dysplasia treated with $Surgibone^{(R)}$ graft and 1 case was aneurysmal bone cyst of the proximal tibia treated with $Lubboc^{(R)}$ graft. Wound infection occurred in 1 case. More transfusion was done in the cases that the lesion was larger than 5cm, the lesions were in the ilium or femur and the cases that were treated with mixed with autograft. This study implies that benign bone tumor is successfully treqated with curettage and xenograft or xenograft mixed with autograft. And also this method will reduce morbidity of donor site, intraoperative bleeding and post-transfusion complications.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.36 no.3
• /
• pp.103-110
• /
• 2014

Purpose: The current gold standard for clinical jawbone formation involves autogenous bone as a graft material. In addition, demineralized dentin can be an effective graft material. Although demineralized dentin readily induces heterotopic bone formation, conventional decalcification takes three to five days, so, immediate bone grafting after extraction is impossible. This study evaluated the effect of vacuum ultrasonic power on the demineralization and processing of autogenous tooth material and documented the clinical results of rapidly processed autogenous demineralized dentin (ADD) in an alveolar defects patient. Methods: The method involves the demineralization of extracted teeth with detached soft tissues and pulp in 0.6 N HCl for 90 minutes using a heat controlled vacuum-ultrasonic accelerator. The characteristics of processed teeth were evaluated by scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). Bone grafting using ADD was performed for narrow ridges augmentation in the mandibular area. Results: The new processing method was completed within two hours regardless of form (powder or block). EDS and SEM uniformly demineralized autotooth biomaterial. After six months, bone remodeling was observed in augmented sites and histological examination showed that ADD particles were well united with new bone. No unusual complications were encountered. Conclusion: This study demonstrates the possibility of preparing autogenous tooth graft materials within two hours, allowing immediate one-day grafting after extraction.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.30 no.6
• /
• pp.554-560
• /
• 2008

In posterior maxilla, it is difficult to achieve primary stability of implants due to sinus pneumatization, alveolar bone loss, and low bone quality. The accurate and objective primary stability assessment is important for good prognosis of implants. Purpose: The aim of this study was to assess the primary stability of the non-submerged, internal type implants with maxillary sinus augmentation using deproteinized bovine bone mineral by a resonance frequency analyzer, when residual alveolar bone height is under 8mm Materials and methods: A total of 20 implants was placed into 5 grafted maxillary sinuses in 5 patients. Deproteinized bovine bone mineral (Bio-$Oss^{(R)}$) was used as graft material. SS II implants (diameter 4.1mm, and length 11.5mm, SLA suface)) were placed. All of the patients received maxillary sinus graft procedure by 1-step technique. Residual bone height was $1.3{\sim}7.8mm$ (mean 4.4mm) measured by panorama radiography. After implant placement, RFA was measured at 4,8,12,20 weeks. The results were divided into 2 groups; RFA value under 4mm and over 5mm of bone height. It was statistically analyzed. Results: 1. The primary stability of implants was increased with time 2. The RFA value was above 65 ISQ at 12 weeks 3. There was no correlation between RFA and residual alveolar bone height in maxillary sinus augmentation by 1-step technique. Conclusion: 1-step surgical procedure is a feasible option for patients with as little as 4mm residual alveolar bone height, when utilizing non-submerged, internal type implants with xenografts.

• Journal of Periodontal and Implant Science
• /
• v.49 no.6
• /
• pp.346-354
• /
• 2019

Maxillary implants are inserted in the upward direction, meaning that they oppose gravity, and achieving stable support is difficult if the alveolar bone facing the maxillary sinus is thin. Correspondingly, several sinus-lifting procedures conducted with or without bone graft materials have been used to place implants in the posterior area of the maxilla. Even with these procedures available, it has been reported that in about 5% of cases, complications occurred after implantation, including acute and chronic sinusitis, penetration of the sinus by the implant, implant dislocation, oroantral fistula formation, infection, bone graft dislocation, foreign-body reaction, Schneiderian membrane perforation, and ostium plugging by a dislodged bone graft. This review summarizes common maxillary sinus pathologies related to implants and suggests an appropriate management plan for patients requiring dental implantation.

• Archives of Reconstructive Microsurgery
• /
• v.16 no.1
• /
• pp.6-13
• /
• 2007

Purpose: To report the clinical results of the vascularized fibular graft in the treatment of intractable infected nonunion of femur. Materials and Methods: We reviewed 3 patients who were performed vascularized fibular graft in treated for intractable infected nonunion of femur. They had received an average of 5.6 times($4{\sim}8\;times$) surgical treatment at different hospitals. 1 case was of a infected nonunion in a fracture treated with internal fixation, the fracture having occurred after resection of a malignant tumor and transplantation of pasteurized autologous bone. 2 cases occurred after internal fixation in closed fractures. Surgical treatment was performed an average of 4 times($3{\sim}5\;times$) at our hospital and in all of the cases debridement of necrotic tissue and sequestrectomy. And vascularized fibular graft was performed. In all cases unilateral external fixation devices were used, of these, 1 case was changed into internal fixation. The final conclusion was made by assessment of functional outcomes and complications according to the standards of Paley. Results: As a result, in all of the cases bone union was achieved, and in the last follow up the functional results were excellent in 2 cases and good in 1 case. There were not presented leg length discrepancy of more than 2 cm, and further loss of knee joint motion. After previous treatment, average 23.3 months($16{\sim}30\;months$) was taken to eliminate infection and achieve complete bone union via vascularized fibular graft in our hospital. Conclusion: In treatment of intractable infected nonunion of femur, fairly good results can be expected after firm fixation, through debridement and vascularized fibular graft.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.38
• /
• pp.26.1-26.6
• /
• 2016

Background: Xenologous or synthetic graft materials are commonly used as an alternative for autografts for guided bone regeneration. The purpose of this study was to evaluate effectiveness of carbonate apatite on the critical-size bone defect of rat's calvarium. Methods: Thirty-six critical-size defects were created on 18 adult male Sprague-Dawley rat calvaria under general anesthesia. Calvarial bones were grinded with 8 mm in daimeter bilaterally and then filled with (1) no grafts (control, n = 10 defects), (2) bovine bone mineral (Bio-$Oss^{(R)}$, Geistlich Pharma Ag. Swiss, n = 11 defects), and (3) hydroxyapatite ($Bongros^{(R)}$, Bio@ Inc., Seongnam, Korea, n = 15 defects). At 4 and 8 weeks after surgery, the rats were sacrificed and all samples were processed for histological and histomorphometric analysis. Results: At 4 weeks after surgery, group 3 ($42.90{\pm}9.33%$) showed a significant difference (p < 0.05) compared to the control ($30.50{\pm}6.05%$) and group 2 ($28.53{\pm}8.62%$). At 8 weeks after surgery, group 1 ($50.21{\pm}6.23%$), group 2 ($54.12{\pm}10.54%$), and group 3 ($50.92{\pm}6.05%$) showed no significant difference in the new bone formation. Conclusions: $Bongros^{(R)}$-HA was thought to be the available material for regenerating the new bone formation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.33 no.4
• /
• pp.350-358
• /
• 2007

The purpose of this study is to evaluate the superficial bony healing after guided bony regeneration using a various bone grafts. Four types of bone grafts were performed by one oral and maxillofacial surgeon to restore the defects around endosseous implants. Group I included the allografts using $Regenaform^{(R)}$. Group 2 included the autograft. Group 3 included the combined grafts using with autogenous symphysis bone and xenograft($BioOss^{(R)}$). Group 4 included the xenograft($BioOss^{(R)}$). After some heling period, superficial bone biopsy was performed with the surgical blade(#15) during the second surgery. Histologic and histomorphmetric examination were carried out by one pathologist. There was the most new bone formation in the group 3, next group 2. However, there were no statistically significant differences. All group except for group 4 showed favorable bone formation and remodeling.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.47 no.4
• /
• pp.269-278
• /
• 2021

Objectives: The purpose of this animal research was to compare bone regeneration in augmented rabbit maxillary sinuses treated with demineralized particulate human-tooth graft and anorganic bovine bone by immunohistochemical analysis. Materials and Methods: Piezoelectric bilateral sinus augmentation was performed in eight adult rabbits. In the control group, anorganic bovine was grafted in the maxillary sinus following elevation of the sinus membrane. In the experimental group, demineralized human particulate tooth bone was grafted in the sinus. Bone regeneration in augmented sinuses was evaluated by immunohistochemical analysis using various markers of osteoprogenitor cells. Results: The number of bromodeoxyuridine-labeled cells was significantly higher in the experimental group than in the control group at eight weeks. The immunoreactivity of proliferating-cell nuclear antigen was increased slightly in the experimental group relative to the control group at eight weeks. Other bone markers were expressed equally in the two groups. Conclusion: In the rabbit maxillary sinus, higher osteoinduction was correlated with demineralized human particulate tooth bone grafting than with anorganic bovine grafting.

• The Journal of Advanced Prosthodontics
• /
• v.3 no.3
• /
• pp.161-165
• /
• 2011

PURPOSE. This randomized clinical trial was conducted to assess the safety and effectiveness of the ErhBMP-2 in alveolar bone regeneration as well as preservation of the ${\beta}$-TCP bone graft material that contains ErhBMP-2. MATERIALS AND METHODS. This study involved 72 patients at the 3 study centers. The patients, who were divided into 2 groups: the experiment group who had ErhBMP-2 coated TCP/HA and the control group who had TCP/HA graft material alone transplanted immediately after tooth extraction. CT was taken before and 3 months after the transplantation and healing status was compared between the two groups. The efficacy endpoints that were used to measure the degree of bone induction included alveolar bone height and 3 measurements of bone width. The paired t test was used to determine the significance of the changes (P<.05). RESULTS. Changes in alveolar bone height were $-1.087{\pm}1.413$ mm in the control group and $-.059{\pm}0.960$ mm in the experimental group (P<.01). At 25% extraction socket length [ESL], the changes were $0.006{\pm}1.149$ mm in the control group and $1.279{\pm}1.387$ mm in the experimental group. At 50% ESL, the changes were $0.542{\pm}1.157$ mm and $1.239{\pm}1.249$ mm, respectively (P<.01 for 25% ESL, and P<.05 for 50% ESL). During the experiment, no adverse reactions to the graft material were observed. CONCLUSION. ErhBMP-2 coated ${\beta}$-TCP/HA were found to be more effective in preserving alveolar bone than conventional ${\beta}$-TCP/HA alloplastic bone graft materials.