• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.6
• /
• pp.504-510
• /
• 2010

Purpose: This study was to examine the proliferation and function of the adipose tissue-derived endothelial cells according to different culture medium conditions. Materials and Methods: Adipose tissue-derived CD146 positive endothelial cells were cultured in according to different culture mediums (DMEM culture medium with or without osteogenic inductive agents and EBM-2 culture medium with or without osteogenic inductive agents). The proliferation and function of the adipose tissue-derived endothelial cells was examined in different culture medium conditions. Results: Adipose tissue-derived endothelial cells formed tube-like structures on Matrigel in EBM-2 culture medium with or without osteogenic inductive agents. However, the cells did not form tube-like structures on Matrigel in DMEM medium with or without osteogenic inductive agents. After 24 hours of culture, among the culture medium using EBM-2, the proliferation of the cells were promoted in EBM-2 medium without osteogenic inductive agents than in EBM-2 medium with osteogenic inductive agents. However, 72 hours of culture, the proliferation of the cells were promoted in EBM-2 medium with osteogenic inductive agents than in EBM-2 medium without osteogenic inductive agents. Conclusion: These results suggest that the proliferation and function of the adipose tissue-derived CD146 positive endothelial cells could be maintained in EBM-2 with osteogenic inductive agents.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.35 no.5
• /
• pp.277-283
• /
• 2013

Purpose: Well vascularized pectoralis major myocutaneous flap (PMMF) had been a commonly used versatile flap in reconstructive oromaxillofacial surgery since the 1970s. However, after the advent of microvascular surgery in the 1980s, the PMMF was used less frequently. But, to date, PMMF has been useful and has some advantages such as covering wide defects, covering vital structures, back-up procedure in cases of free flap failure, and reconstruction for radiotherapy patients. The purpose of this study is to evaluate the role, indication, complications, functional, and aesthetic results of this flap in the era of free flap with a literature and chart review. Methods: A retrospective study was conducted of 16 oral cancer patients undergoing reconstructive surgery with PMMF for reconstruction of defects from 2001 to 2012 at Kyungpook National University Hospital. The male to female ratio was 10:6, with a mean age of 63 years (16~79 years). Basic demographic data, previous treatment history, indications, dimension of the flap, site of reconstruction, postoperative complications, and patients' final status were systemically analyzed from chart review. Results: The pathology of the disease included squamous cell carcinoma in the majority of cases (n=14). The remaining cases were fibrosarcoma and mucoepidermoid carcinoma. Of the 16 PMMF reconstructions, 13 flaps were applied as primary reconstructive procedures, whereas three flaps were; salvage; procedures (vascularized free flap failure). Twelve patients had complications such as wound dehiscence, infection, hematoma, fistula, flap bulkiness, and partial flap necrosis. The higher complication rates showed an association with utilization of the flap in preoperative radiotherapy cases. However, all patients were discharged without failure. Conclusion: In reconstructive oromaxillofacial surgery, the PMMF is still a useful flap for huge defects. In addition, the PMMF can be used as a salvage procedure after vascularized free flap failure and reconstruction for patients with a history of preoperative radiotherapy.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.38
• /
• pp.42.1-42.7
• /
• 2016

Background: The purpose of this retrospective study was to evaluate the clinical utility of an implant with a sandblasted, large-grit, acid-etched (SLA) surface and internal connection. Methods: Six patients who received dental implants in the Department of Oral and Maxillofacial Surgery, Chonnam National University Dental Hospital, were analyzed by factors influencing the success rate and marginal bone loss. Factors included patient's age, sex, implant installation site, whether bone graft was done, type of bone graft materials, approaching method if sinus lift was done, and the size of the fixture. In addition, the marginal bone loss was analyzed by using a radiograph. Results: All implants were successful, and the cumulative survival rate was 100 %. Average marginal bone loss of 6 months after the installation was 0.52 mm and 20 months after the functional loading was 1.06 mm. Total marginal bone resorption was 1.58 mm on average. There was no statistically significant difference in mesial and distal marginal bone loss. Conclusions: The short-term clinical success rate of the implant with an SLA surface and internal connection was satisfactory. Moreover, the marginal bone loss was also consistent with the implant success criteria.

• Korean Institute of Interior Design Journal
• /
• v.16 no.2 s.61
• /
• pp.262-269
• /
• 2007

The blur phenomenon obscuring the boundary between the field of designers and that of users may be the key paradigm in the 21st century. However, we observed a number of chair design cases that could be considered as the results of blur pheonomenon in the furniture design field from mid 1960s. The backgrounds include the repulsion against the uniform functionalism, deliberation on the life in the future and the development of plastic materials and their processing methods. Under such backgrounds, the designers pursued the new and futuristic furniture design. In that process, what is about the "freedom" that the consumers as well as the designers should have in using the furniture was the important concept. This concept enabled the creation of chair design inducing the participation of consumers. They created various kinds of shapes, functions and structures that the consumers became interested in as if they had fun with toy blocks by mainly using the new material "plastic". In a formative aspect, the entire shape is classified into the organic shape and geometric shape. The unit types are divided into two kinds; type that the unit of simple shape is repeated only with size difference and irregular combination type of the units comprised of more than two shapes. In the functional aspect, some cases showed the transformation and expansion of the function more variously. Other cases changed the function of chairs to tables, cabinets, or objects. In the structural aspect, on the basis of the method assembling each unit, one method is to assemble using the hardware and the other is to assemble only with intrinsic units of chair. The chair design created by the blur phenomenon between the designers and the users as described above causes the blur phenomenon between the furniture and the space where the furniture is installed. Accordingly, it is expanding the furniture design sphere including the case that the furniture is not selected as the rifle article depending on the characteristics of interior space but it becomes the element leading the characteristics of space. This study aims to estimate the change of interior space and the furniture that my cause the blur phenomenon by examining the cases above appropriate for the paradigm of the 21st century. Furthermore, this study will enable the discussion oil the directions of future furniture design based on its results.

• Geomechanics and Engineering
• /
• v.13 no.2
• /
• pp.195-215
• /
• 2017

This paper proposes gob-side entry retaining by roof break and filling in thick-layer soft rock conditions based on the thick-layer soft rock roof strata migration law and the demand for non-pillar gob-side entry retaining projects. The functional expressions of main roof subsidence are derived for three break roof direction conditions: lateral deflection toward the roadway, lateral deflection toward the gob and vertically to the roof. These are derived according to the load-bearing boundary conditions of the main roadway roof stratum. It is concluded that the break roof angle is an important factor influencing the stability of gob-side entry retaining surrounding rock. This paper studies the stress distribution characteristics and plastic damage scope of gob-side entry retaining integrated coal seams, as well as the roof strata migration law and the supporting stability of caving structure filled on the break roof layer at the break roof angles of $-5^{\circ}$, $0^{\circ}$, $5^{\circ}$, $10^{\circ}$ and $15^{\circ}$ are studied. The simulation results of numerical analysis indicate that, the stress concentration and plastic damage scope to the sides of gob-side entry retaining integrated coal at the break roof angle of $5^{\circ}$ are reduced and shearing stress concentration of the caving filling body has been eliminated. The disturbance of coal mining to the roadway roof and loss of carrying capacity are mitigated. Field tests have been carried out on air-return roadway 5203 with the break roof angle of $5^{\circ}$. The monitoring indicates that the break roof filling section and compaction section are located at 0-45 m and 45-75 m behind the working face, respectively. The section from 75-100 m tends to be stable.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.28 no.2
• /
• pp.118-126
• /
• 2006

In oral and maxillofacial surgery, bone graft is very important procedure for functional and esthetic reconstruction. So, many researcher studied about bone graft material like autogenous bone, allograft bone and artificial bone materials. The purpose of this study is to evaluate the quantity of bone generation induced by $Grafton^{(R)}$ graft, human allogenic demineralized bone matrix. Total 24 sites of artificial bony defects prepared using trephin bur(diameter 8 mm) on parietal bone of six adult New Zealand White rabbits. Experimental group had six defect sites which grafted $Grafton^{(R)}$(0.1 cc). Active control group had nine defect sites, into which fresh autogenous bone harvested from own parietal bone was grafted and passive control group had nine defect sites without bone graft. After six weeks postoperatively, the rabbits were sacrificed. The defects and surrounding tissue were harvested and decalcified in 10% EDTA, 10% foamic-acid. Specimens were stained with H&E. New bone area percentage in whole defect area was measured by IMT(VT) image analysis program. Quantity of bone by $Grafton^{(R)}$ graft was smaller than that of autograft and larger than that of empty defects. In histologic view $Grafton^{(R)}$ graft site and autograft site showed similar healing progress but it was observed that newly formed bone in active control group was more mature. In empty defect, quantity and thickness of new bone formation was smaller than in $Grafton^{(R)}$-grafted defect. $Grafton^{(R)}$ is supposed to be a useful bone graft material instead of autogenous bone if proper maintenance for graft material stability and enough healing time were obtained.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.17 no.1
• /
• pp.60-72
• /
• 1995

Temporomandibular joint ankylosis is the movemental obstacle of mandible which depend on proliferation of bony or fibrous tissue in temporomandibular joint structure by various causes. In order to treat this, various surgical methods have been performed, but no operative methods have been produced consistently successful results. This research has been performed to the patients who had been operated due to temporomandibular joint ankylosis by studying classification, cause, onset, duration, anesthesia and treatment method, symptom, change of mouth opening, complication through medical record, X-ray, follow-up for being a help to proper selection of treatment method and evaluation of prognosis. The author obtained the following results by analyzing 44 cases among patients who had been operated due to temporomandibular joint ankylosis during 8 year hospitalization from 1986 to 1993 in Dept. of Oral & Maxillofacial Surgery of Seoul National University Hospital. 1. The occurrence was in the order of below 10, 20's, 10's, 30's. The average of occurrence was 12.95. Illness period was 50.0% within 10 years and 50% beyond 10 years. The average period of illness was 13.33 years. 2. Trauma occupied 54.5% of causes and inflammation occupied 45.5%. Men had more occurrences due to trauma and there was no difference in case of inflammation. 3. In nasotracheal intubations for general anesthesia, the cases of using fiberoptic laryngoscope occupied 40.9%, direct or blind nasotracheal intubation occupied 40.9% and the cases of using tracheostomy occupied 18.2%. 4. In operative approaching methods, submandibular & preauricular approach were mainly applied, and in operative methods, high condylectomy(Group I) occupied 11.4%, arthroplasty without interpositional material following condylectomy or gap ostectomy(Group II) occupied 11.4%, with interpositional material following high condylectomy (Group III) occupied 40.9%, and using condylar reconstruction following condylectomy or gap ostectomy(Group IV) occupied 36.6%. 5. In change of mouth opening reformed after surgery, Group III showed the best result of average 23.5mm, Group IV showed 16.3mm, Group I showed 14.9mm and Group II showed 10.2mm of reformation. Summarizing the results as written above, it is considered that early treatment is important as soon as possible in Temporomandibular joint ankylosis. It is recommended in surgical method what can lead to postoperative early movement maintaining anatomaical & functional form, and then the development of various surgical methods will be requested.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.43.1-43.5
• /
• 2019

Background: Reconstructive surgery is often required for tumors of the oral and maxillofacial region, irrespective of whether they are benign or malignant, the area involved, and the tumor size. Recently, three-dimensional (3D) models are increasingly used in reconstructive surgery. However, these models have rarely been adapted for the fabrication of custom-made reconstruction materials. In this report, we present a case of maxillary reconstruction using a laboratory-engineered, custom-made mesh plate from a 3D model. Case presentation: The patient was a 56-year-old female, who had undergone maxillary resection in 2011 for intraoral squamous cell carcinoma that presented as a swelling of the anterior maxillary gingiva. Five years later, there was no recurrence of the malignant tumor and a maxillary reconstruction was planned. Computed tomography (CT) revealed a large bony defect in the dental-alveolar area of the anterior maxilla. Using the CT data, a 3D model of the maxilla was prepared, and the site of reconstruction determined. A custom-made mesh plate was fabricated using the 3D model (Okada Medical Supply, Tokyo, Japan). We performed the reconstruction using the custom-made titanium mesh plate and the particulate cancellous bone and marrow graft from her iliac bone. We employed the tunneling flap technique without alveolar crest incision, to prevent surgical wound dehiscence, mesh exposure, and alveolar bone loss. Ten months later, three dental implants were inserted in the graft. Before the final crown setting, we performed a gingivoplasty with palate mucosal graft. The patient has expressed total satisfaction with both the functional and esthetic outcomes of the procedure. Conclusion: We have successfully performed a maxillary and dental reconstruction using a custom-made, pre-bent titanium mesh plate.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.19.1-19.6
• /
• 2019

Background: The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy. Case presentation: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal. Conclusions: Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.30.1-30.8
• /
• 2019

Background: Advancements in the field of microvascular surgery and the widespread adoption of microvascular surgical techniques have made the use of osteocutaneous fibula free flaps the standard of care in the surgical management of segmental mandibular defects. Although the literature possesses abundant evidence to support the effectiveness of fibula free flaps as a reconstructive method, there are relatively few studies reporting on outcomes as objectively measured by videofluoroscopic swallowing studies (VFSS). The purpose of this study is to explore the potential correlation between early postoperative VFSS and the long-term swallowing outcomes in patients who underwent mandibular reconstruction with fibula free flaps. Methods: We performed a retrospective chart review of 36 patients who underwent mandibular reconstruction with osteocutaneous fibular free flaps between 2009 and 2012. Demographics, clinical variables, VFSS data, and diet information were retrieved. Penetration and aspiration findings on VFSS, long-term oral feeding ability, and the need for gastrostomy tube were statistical endpoints correlated with postoperative clinical outcomes. Results: Thirty-six patients were reviewed (15 females and 21 males) with a mean age of 54 years (7-81). Seventeen cases were treated for malignancy. The size of the bony defect ranged from 3 to 15 cm (mean = 9 cm). The cutaneous paddle, a surrogate for soft tissue defect, ranged from 10 to 125 ㎠ (mean = 52 ㎠). A gastrostomy tube was present in patients preoperatively (n = 8), and postoperatively (n = 14). Seventeen patients had neoadjuvant exposure to radiation. Postoperative VFSS showed penetration in 13 cases (36%) and aspiration in seven (19%). Overall, 29 patients (80.6%) achieved unrestricted diet, and this was statistically correlated with age (p = 0.037), radiation therapy (p = 0.002), and preoperative gastrostomy tube (p = 0.03). The presence of penetration or aspiration on VFSS was a strong predictor for long-term unrestricted oral diet (p < 0.001). Conclusion: Early postoperative VFSS is an excellent predictor for long-term swallowing outcomes in patients undergoing mandibular reconstruction with osteocutaneous fibula free flaps.