• Archives of Plastic Surgery
• /
• v.40 no.4
• /
• pp.374-379
• /
• 2013

Background To date, various types of acellular dermal matrix (ADM) have been developed for clinical use. AlloDerm is the most familiar type of ADM to most surgeons in breast reconstruction. It is prepared by freeze-drying. CG CryoDerm is the first form of ADM that requires no drying process. Therefore, theoretically, it has a higher degree of preservation of the dermal structures than AlloDerm. We conducted this study to compare the clinical course and postoperative outcomes of patients who underwent direct-to-implant breast reconstructions using AlloDerm and those who did using CG CryoDerm. Methods We performed a retrospective analysis of the medical records in a consecutive series of 50 patients who underwent direct-to-implant breast reconstruction using AlloDerm (n=31) or CryoDerm (n=19). We then compared the clinical course and postoperative outcomes of the two groups based on the overall incidence of complications and the duration of drainage. Results The mean follow-up period was 16 months. There were no significant differences in the overall incidence of complications (seroma, infection, skin flap necrosis, capsular contracture, and implant loss) between the two groups. Nor was there any significant difference in the duration of drainage. Conclusions CG CryoDerm has the merits of short preparation time and easy handling during surgery. Our results indicate that CG CryoDerm might be an alternative allograft material to AlloDerm in direct-to-implant breast reconstruction.

• Archives of Plastic Surgery
• /
• v.49 no.2
• /
• pp.158-165
• /
• 2022

Background Implant-based breast reconstruction has evolved tremendously in the last decades, mainly due to the development of new products and techniques that make the procedure safer and more reliable. The purpose of this study was to compare the outcomes in immediate one-stage breast reconstruction between acellular dermal matrix (ADM) and inferior dermal flap (IDF). Methods We conducted a retrospective comparative study of patients submitted to immediate breast reconstructions with an anatomical implant and ADM or IDF in a single center between 2016 and 2018. Outcomes evaluated included major complications, early complications, reinterventions, readmissions, and reconstruction failure. Simple descriptive statistics and univariate analysis were performed. Results A total of 118 breast reconstructions (85 patients) were included in the analysis. Patients in the IDF group had a higher body mass index (median = 27.0) than patients in the ADM group (median = 24). There were no statistically significant differences among both groups regarding immediate major complication, early complications, readmissions, and reinterventions. Conclusion There are no significant differences in complications between the ADM and IDF approach to immediate implant breast reconstruction. In patients with higher body mass index and large, ptotic breasts, we recommend an immediate implant reconstruction with IDF.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.38
• /
• pp.16.1-16.9
• /
• 2016

Background: The association of biomaterial combined with repair factor-like platelet-rich plasma (PRP) has prospective values. Bovine-derived xenograft has been identified as an osteoconductive and biocompatible grafting material that provides osseointegration ability. PRP has become a valuable adjunctive agent to promote healing in a lot of dental and oral surgery procedures. However, there are controversies with respect to the regenerative capacity of PRP and the real benefits of its use in bone grafts. The purpose of this study was to assess the influence of PRP combined with xenograft for the repair of peri-implant bone defects. Methods: Twelve rabbits were used in this study, and the experimental surgery with implant installation was performed simultaneously. Autologous PRP was prepared before the surgical procedure. An intrabony defect (7.0 mm in diameter and 3.0 mm deep) was created in the tibia of each rabbit; then, 24 titanium dental implants (3.0 mm in diameter and 8.5 mm long) were inserted into these osteotomy sites. Thus, a standardized gap (4.0 mm) was established between the surrounding bony walls and the implant surface. The gaps were treated with either xenograft alone (control group) or xenograft combined with PRP (experimental group). After healing for 1, 2, 3, 4, 5, and 6 weeks, the rabbits were sacrificed with an overdose of KCl solution. Two rabbits were killed at each time, and the samples including dental implants and surrounding bone were collected and processed for histological analysis. Results: More newly formed bone and a better bone healing process were observed in control group. The histomorphometric analysis revealed that the mean percentage of bone-to-implant contact in the control group was significantly higher than that of the experimental group (25.23 vs. 8.16 %; P < 0.05, independent-simple t test, analysis of variance [ANOVA]). Conclusions: The results indicate that in the addition of PRP to bovine-derived xenograft in the repair of bone defects around the implant, PRP may delay peri-implant bone healing.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.5
• /
• pp.402-407
• /
• 2010

Introduction: The planning of implant surgery is an important factor for the implant prosthesis. Stereolithographic (SLA) surgical stents based on a computer simulation are quite helpful for clinicians to perform the surgery as planned. Although many clinical and technical trials have been performed for computed tomography (CT)-guided implant stents to improve the surgical procedures and prosthetic treatment, there are still many problems to solve. We developed a system of a surgical guide based on 3 dimensional (3D) CT for implant therapy and achieved satisfactory results in the terms of planning and operation. Materials and Methods: Fifteen patients were selected and 30 implant fixtures were installed. The preoperative CT data for surgical planning were prepared after obtaining informed consent. Surgical planning was performed using the simulation program, Ondemend3D In2Guide. The stents were fabricated based on the simulation data containing information of the residual bone, the location of the nerve, and the expected design of the prostheses. After surgery with these customized stents, the accuracy and reproducibility of implant surgery were evaluated based on the computer simulation. The data of postoperative CT were used to confirm this system using the image fusion technique and compare the implant fixtures between the planned and implanted. Results: The mean error was 1.18 (${\pm}0.73$) mm at the occlusal center, 1.23 (${\pm}0.67$) mm at the apical center, and the axis error between the two fixtures was $3.25^{\circ}C$ (${\pm}3.00$). These stents showed superior accuracy in maxilla cases. The lateral side error at the apical center was significantly different from the error at the occlusal center but there were no significant differences between the premolars, 1st molars and 2nd molars. Conclusion: SLA surgical stents based on a computer simulation have the satisfactory accuracy and are expected to be useful for accurate planning and surgery if some errors can be improved.

• Journal of Korean Dental Science
• /
• v.4 no.2
• /
• pp.59-66
• /
• 2011

Purpose: This research sought to determine the resorption rate of bone grafted to the maxillary sinus according to the grafted material's type, patient's age, systemic disease, implant size, site of implant placement, and residual ridge height. Materials and Methods: This research targeted 24 patients who had immediate Osstem$^{(R)}$ implant (US Plus$^{(R)}$) placement after bone graft. The panorama was taken before the surgery, after the surgery, and 6 months after the surgery. Vertical height change and resorption rate of the grafted bone were measured with the same X-rays and compared. The influence of the following factors on the grafted bone material's resorption rate was evaluated: grafted material type, patient's age, systemic disease, implant size, site of implant placement, and residual ridge height. Results: Patients in their 40s had $34.0{\pm}21.1%$ resorption rate, which was significantly higher compared to the other age groups (P<0.05). There was no significant relationship between systemic disease and grafted bone resorption. There was no significant relationship between implant size (diameter, length) and grafted bone resorption. There was no significant relationship between the site of implant placement and grafted bone resorption. The ramal bone-grafted site was significantly more resorbed than the ramal bone/Bio-Oss$^{(R)}$-grafted site, maxillary tuberosity bone/Bio-Oss$^{(R)}$-grafted site, and ramal bone/maxillary tuberosity bone/Bio-Oss$^{(R)}$-grafted site (P<0.05). There was no significant difference in the grafted bone resorption rate in the sinus between more than 4 mm and less than 4 mm residual ridge heights. After an average of 6 months, a second surgery was done; given an average follow-up of 1.9 years, the success rate and survival rate of the implant were 96.9% and 98.4%, respectively. Conclusion: These results indicate that the bone resorption rate of grafted bone among patients in their 40s is higher compared to patients in their 50s and over, and that only autogenous bone (ramus) shows higher resorption rate than the mixed graft of autogenous bone and xenogenous graft (Bio-oss) after maxillary sinus graft.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.20 no.2
• /
• pp.166-172
• /
• 1998

Missing of the upper posterior dentition can cause alveolar bone resorption & pneumatization of Maxillary sinus wall, which makes traditional implant placement impossible, The solution includes various methods to the posterior maxilla to provide adequate bone support for implant installation and long-term survival. -- sinus floor elevation, sinus-lift graft, inlay graft using LeFort I osteotomy, onlay graft, This is a clinical Sr. retrospective study on implant surgery & prosthodontic restoration with upper edentulous posterior jaw from Jan. 1990. to Jun. 1997 at implant clinic of Chonbuk National University Hospital. The results obtained were as follows: 1. Six hundred ninety-nine implants were placed on upper posterior jaw of two hundred seventeen patients, among them one hundred sixty-five implants were placed in forty-four patients with sinus lift. 2. The height of the remained alveolar bone was classified on the base of Misch's concept. This included seventy-nine SA-1s, ninety-seven SA-2s, sixty-five SA-3s and sixty SA-4s. 3. Ninety percent of implants were successfully integrated in non-grafted area and eighty-seven percent of implants were successully integrated in sinus lift area.

• Archives of Plastic Surgery
• /
• v.34 no.6
• /
• pp.792-795
• /
• 2007

Purpose: Scoliosis is a multifactorial disorder caused by genetic, biochemical, developmental, neuromuscular factors and causes complex deformities which include skeletal deformity, pain, cardiovascular dysfunction, motor function disorder. Until now, the treatment of scoliosis have been focused on orthopedic correction, preservation of cardiopulmonary and neurologic function. But recently, as aesthetic demands increases, the needs for the correction or improvement of the trunk and extremity contour does. So, the correction of soft tissue contour deformity can be a new concept for the treatment of scoliosis. Methods: We corrected a deformed contour with prefabricated silicone implant in a scoliosis patient who had been operated for orthopedic correction previously. Submuscular pocket was made under trapezius and latissimus dorsi muscle. Silicone implant was placed in the pocket and fixed to thoracolumbar fascia with sutures. Results: We had a satisfactory results for the correction of contour deformity. There was no significant complication. Conclusion: Silicone implant is a new trial for the correction of scoliosis contour deformity. This method is simple, safe and brings on satisfactory results.

• Archives of Craniofacial Surgery
• /
• v.18 no.1
• /
• pp.59-61
• /
• 2017

As the number of people who have undergone augmentation rhinoplasty has increased recently, nasal fractures are becoming more common after rhinoplasty. A silicone implant can affect the nasal fracture pattern, but there is no significant difference in treatment methods commonly. A 28-year-old female who had undergone augmentation visited our clinic with a nasal fracture. Computed tomography revealed that the silicone implant was sandwiched between the intact nasal bones with fractured bone fragments. In this case, open reduction was inevitable and a new silicone implant was inserted after reduction. Migration of the silicone implant beneath the nasal bone is a very rare phenomenon, but its accurate prevention and diagnosis is important because a closed reduction is impossible.

• Archives of Plastic Surgery
• /
• v.47 no.4
• /
• pp.360-364
• /
• 2020

In this report, we present a rare case of solid silicone implant displacement to the contralateral side after aesthetic gluteal augmentation, a phenomenon that has never been reported before in the literature. A 29-year-old woman with a history of gluteal augmentation 9 months previously and soft tissue infection presented for a consultation due to 3 days of sudden progressive pain in the right gluteus with erythema and edema, without a history of trauma. Displacement of the left gluteal implant to the right gluteal pocket was shown by magnetic resonance imaging. Because the patient refused implant removal, the decision was made to perform capsulotomy, to reconstruct the gluteal pockets, and to preserve the implants. The patient showed a satisfactory early and late postoperative course. Possible causes of this complication include poor surgical technique, with insufficient tissue preservation to keep the pockets apart, and the presence of seroma or hematoma that favored an infectious process, thereby leading to deterioration of the dissected soft tissues with dehiscence of the wound favoring the displacement of the implant.

• Archives of Craniofacial Surgery
• /
• v.20 no.5
• /
• pp.319-323
• /
• 2019

Cochlear implant extrusion, which is a common complication of cochlear implants, is generally repaired by a well visualized soft-tissue flap. A 61-year-old female patient with a medical history of schizophrenia who had a skin ulcer that caused cochlear implant extrusion, but that would be a stronger statement was referred to our department for removal of the implant and reconstruction of the resultant scalp defect. Accordingly, the broad defect was covered via rotation of a temporoparietal fascia flap (TPFF) using the superficial temporal artery, with the pedicle in the preauricular region as the pivot point. Coverage of TPFF was achieved with a split-thickness skin graft using the scalp as the donor site, which led to a quick recovery after the operation and satisfactory results in terms of aesthetics. This case suggests that a TPFF might be used as a flexible flap with low donor site morbidity for reconstructing cases of cochlear implant extrusion accompanied by a large full-layer scalp defect.