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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Maxillofacial Plastic and Reconstructive Surgery
Journal Basic Information
Journal DOI :
Korean Association of Maxillofacial Plastic and Reconstructive Surgeons
Editor in Chief :
Volume & Issues
Volume 30, Issue 6 - Nov 2008
Volume 30, Issue 5 - Sep 2008
Volume 30, Issue 4 - Jul 2008
Volume 30, Issue 3 - May 2008
Volume 30, Issue 2 - Mar 2008
Volume 30, Issue 1 - Jan 2008
Selecting the target year
AN EXPERIMENTAL STUDY AND CASE ANALYSIS OF ACELLULAR DERMAL MATRIX IMPLANTATION FOR RESTORATION OF SOFT TISSUE DEFECTS
Ryu, Sun-Youl ; Ryu, Jae-Young ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 1~10
Purpose: This study was aimed to examine the resorption rate, the healing pattern, and the response of the surrounding tissue after the graft of the acellular dermal matrix (
) and the autogenous dermis, and to report the clinical result of the use of
in order to restore the soft tissue defects. Methods: Twenty mature rabbits, weighing about 3 ㎏, were used for the experimental study. The
mm-size autogenous dermis and the
were grafted to the space between the external abdominal oblique muscle and the fascia of the rabbits. And the
was grafted to the pocket between the skin and the underlying perichondrium of rabbit ear. The resorption rate of the grafted sites was calculated, and the tissue specimens were histologically examined at 1, 2, 4, and 8 weeks after the graft. The five patients with the cleft-lip nasal deformity and the one patient with the saddle nose deformity, who received the
graft to restore the facial soft tissue defects, were reviewed for the clinical study. Results: The resorption rate at 8 weeks after the graft was 21.5% for the autogenous dermis, and 16.0%
. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. However, the neovascularization and the progressive growth of the new fibroblasts were shown in the
graft. And the six patients, who received the
graft, demonstrated the good stability of the grafts and improved appearance. There were no remarkable complications such as inflammation, rejection, dislocation, and severe absorption in the clinical cases. Conclusion: These results suggest that
can be an useful graft material for restoration of soft tissue defects because of the good stability and the tissue response without the remarkable clinical complications.
HSP27 EXPRESSION IN OSTEOBLAST BY THERMAL STRESS
Rim, Jae-Suk ; Kim, Byeong-Ryol ; Kwon, Jong-Jin ; Jang, Hyon-Seok ; Lee, Eui-Suk ; Jun, Sang-Ho ; Woo, Hyeon-Il ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 11~21
Aim of the study: Thermal stress is a central determinant of osseous surgical outcomes. Interestingly, the temperatures measured during endosseous surgeries coincide with the temperatures that elicit the heat shock response of mammalian cells. The heat shock response is a coordinated biochemical response that helps to protect cells from stresses of various forms. Several protective proteins, termed heat shock proteins (hsp) are produced as part of this response. To begin to understand the role of the stress response of osteoblasts during surgical manipulation of bone, the heat shock protein response was evaluated in osteoblastic cells. Materials & methods: With primary cell culture studies and ROS 17/2.8 osteoblastic cells transfected with hsp27 encoding vectors culture studies, the thermal stress response of mammalian osteoblastic cells was evaluated by immunohistochemistry and western blot analysis. Results: Immunocytochemistry indicated that hsp27 was present in unstressed osteoblastic cells, but not fibroblastic cells. Primarily cultured osteoblasts and fibroblasts expressed the major hsp in response to thermal stress, however, the small Mr hsp, hsp27 was shown to be a constitutive product only in osteoblasts. Creation of stable transformed osteoblastic cells expressing abundant hsp27 protein was used to demonstrate that hsp27 confers stress resistance to osteoblastic cells. Conclusions: The demonstrable presence and function of hsp27 in cultured bones and cells implicates this protein as a determinant of osteoblastic cell fate in vivo.
AN EXPERIMENTAL STUDY ON FAT CELL VIABLITY ACCORDING TO DIFFERENT HARVESTING TECHNIQUES
Lee, Won-Deok ; Choi, Jin-Young ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 22~29
Purpose: The purpose of this study is to test the efficacy of various methods of fat harvesting in animal model by viability comparison with assay including cell counting, MTT assay, and histologic evaluation. Materials and methods: New Zealand white rabbits experiments were used. Groin fat pads were subjected to different harvest method varying ingredients of solution(Experiment 1: T1 solution= lidocaine 1000mg/L, epinephrine 1mg/L, sodium bicarbonate 10mgEq/L, Triamcinolone 10mgEq/L; T2 solution=lidocaine 1000mg/L, epinephrine 1mg/L, sodium bicarbonate 0mgEq/L, Triamcinolone 0mgEq/L) and pressure exerted on harvesting with Luer-Lock syringe connected to suction cannula.(Experiment 2: P1 group=3cc intermittent pressure; P2 group=10cc sustained pressure) Fat cell viability was assessed with cell counting with a hemocytometer, MTT assay, and histologic evaluation. Results: Experiment 1 Cell count: T1=2.4/3.4/4.2, T2=9.6/8.4/7.2(
per mL); MTT assay: T1=0.516/0.41/0.453/0.412/0.421, T2=0.925/0.765/0.54/0.634/0.614 in 21 days(absorbance); Histology: T1 showed elongated and, different in size and shape, and ruptured adipocytes with only a few normal adipocytes whereas T2 showed central core of fat with almost intact fat cells Experiment 2 Cell count: P1=1.2/3.2/4.2, P2=1.2/2.4/3.8(
per mL); MTT assay:P1=0.256/0.245/0.258/0.21/0.264, P2=0.12/0.231/0.245/0.313/0.281 in 21 days(absorbance); Histology: P1 showed somewhat evenly distributed normal-looking fat cells and P2 showed relatively irregular shape of fat cells with small blood vessel amongst adiopocytes. Conclusion: Viability was higher in ‘modified tumescent solution’without sodium bicarbonate and triamcinolone and we also found no significantly different viability between using intermittent pressure and using sustained pressure. But in terms of initial viability of fat cell, we can assume that lower intermittent pressure would make better clinical results.
COX-2 INHIBITOR INDUCED APOPTOSIS IN ORAL SQUAMOUS CELL CARCINOMA CELL LINE THROUGH AKT PATHWAY
Seo, Young-Ho ; Han, Se-Jin ; Lee, Jae-Hoon ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 30~40
The objectives of this study was to check up the effect of celecoxib, COX-2 inhibitor, on the pathogenesis of oral squamous cell carcinoma. After mefenamic acid, aspirin and celecoxib, COX-2 inhibitor, were inoculated to HN 22 cell line, the following results were obtained through tumor cell viability by wortmannin, growth curve of tumor cell line, apoptotic index, PGE2 synthesis, total RNA extraction, RT-PCR analysis and TEM features. 1. When wortmannin and celecoxib were given together, the survival rate of tumor cells was lowest about 47 %. So wortmannin had an effect on the decrease of survival rate of tumor cells. 2. In growth curve, the slowest growth was observed in celecoxib inoculated group. 3. The synthesis of PGE2 was decreased in all group and the obvious suppression and highest apoptotic index was observed in celecoxib inoculated group. 4. Suppression of expression of COX-2 mRNA was evident in celecoxib inoculated group. But that of COX-1,2 mRNA was observed in mefenamic acid inoculated group and aspirin inoculated group. 5. In celecoxib inoculated group, mRNA expression of AKT1 was decreased and that of PTEN & expression of caspase 3 and 9 was evidently increased. Depending on above results, when celecoxib was inoculated to oral squamous cell carcinoma cell line, an increase of mRNA expression of caspase 3,9 and PTEN is related to a decrease of mRNA expression of AKT1. Wortmannin had an effect on the decrease of survival rate of tumor cells. Celecoxib might induce apoptosis of tumor cell by suppression of AKT1 pathway and COX-2 inhibition. This results suggested that COX-2 inhibitor might be significantly effective in chemoprevention of oral squamous cell carcinoma.
EXPRESSION OF THE GENES OF VASCULAR ENDOTHELIAL GROWTH FACTOR AND VON WILLEBRAND FACTOR IN SALIVARY GLAND TUMORS
Chung, Ji-Hun ; Kim, Ji-Hyuk ; Park, Young-Wook ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 41~51
Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor which compromises about 6
8% of all tumors followed by the adenoid cystic carcinoma (ACC) and adenocarcinoma. Most deaths from salivary carcinomas are caused by recurrent or metastatic lesions that are resistant to conventional therapy. Therefore, knowledge of cellular properties and tumor-host interactions that influence the vascular metastasis is important for the design of more effective therapy of salivary carcinomas. Neoangiogenesis is essential for tumor growth, which is postulated to be fundamentally dependent on the induction of stromal neovascularization. However, how neovascularization takes place in live tissue has not been fully established, especially in recruitment and differentiation of endothelial cells in the salivary gland tumors. Vascular endothelial growth factor (VEGF) is a heparin-binding, dimeric polypeptide growth factor known to exert its mitogenic activity specifically on endothelial cells. VEGF has been shown th be directly involved in angiogenesis, which in essential for the pathogenesis of many solid tumors. von Willebrand factor (vWF) is a large multimeric protein synthesized by megakaryocytes and endothelial cells that enable platelets to adhere to exposed subendothelium and, as well, to respond to changes in the blood flow. Recent studies suggest that increased levels of vWF correlate with progression of disease, metastasis, or survival time and thus may have a prognostic significance. vWF is explained as an acute phase proteins which is increased in cancer or as a result of increased endothelial cell synthesis associated with tumor-induced angiogenesis. Due to adhesive properties of vWF, its increased concentrations may also contribute metastasis of tumor. In this study, we determined the mRNA expression of VEGF and vWF in salivary ACC, MEC and pleomorphic adenoma by in situ hybridization. As a result, stronger expression of VEGF and vWF was seen in salivary ACC and MEC which has more invasive nature than the salivary benign tumor.
AN EXPERIMENTAL STUDY ON THE OSSEOINTEGRATION OF THE TI-6AL-4V BEAD COATING IMPLANTS
Woo, Jin-Oh ; Park, Bong-Wook ; Byun, June-Ho ; Kim, Seung-Eon ; Kim, Gyoo-Cheon ; Park, Bong-Soo ; Kim, Jong-Ryoul ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 52~59
The geometric design of an implant surface may play an important role in affecting early osseointegration. It is well known that the porous surfaced implant had much benefits for the osseointegration and the early stability of implant. However, the porous surfaced implant had weakness from the transgingival contamitants, and it resulted in alveolar bone loss. The other problem identified with porous surface implant is the loss of physical properties resulting from the bead sintering process. In this study, we developed the new bead coating implant to overcome the disadvantages of porous surfaced implant. Ti-6Al-4V beads were supplied from STARMET (USA). The beads were prepared by a plasma rotating electrode process (PREP) and had a nearly spherical shape with a diameter of 75-150
. Two types of titanium implants were supplied by KJ Meditech (Korea). One is an external hexa system (External type) and the other is an internal system with threads (Internal type). The implants were pasted with beads using polyvinylalcohol solution as a binder, and then sintered at 1250
for 2 hours in vacuum of
torr. The resulting porous structure was 400-500
thick and consisted of three to four bead layers bonded to each other and the implant. The pore size was in the range of 50-150
and the porosity was 30-40 % in volume. The aim of this study was to evaluate the osseointegration of the newly developed dental implant. The experimental implants (n=16) were inserted in the unilateral femur of 4 mongrel dogs. All animals were killed at 8 weeks after implantation, and samples were harvested for hitological examination. All bead coated porous implants were successfully osseointegrated with peripheral bone. The average bone-implant contact ratios were 84.6 % (External type) and 81.5 % (Internal type). In the modified Goldner's trichrome staining, new generated mature bones were observed at the implant interface at 8 weeks after implantation. Although, further studies are required, we could conclude that the newly developed vacuum sintered Ti-6Al-4V bead coating implant was strong enough to resist the implant insertion force, and it was easily osseointegrated with peripheral bone.
THE THREE DIMENSIONAL FINITE ELEMENT ANALYSIS OF THE STRESS DISTRIBUTION ACCORDING TO THE THREAD DESIGNS AND THE MARGINAL BONE LOSS OF THE IMPLANTS
Kim, Il-Kyu ; Son, Choong-Yul ; Jang, Keum-Soo ; Cho, Hyun-Young ; Baek, Min-Kyu ; Park, Sheung-Hoon ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 60~71
The objective of this study is to evaluate the stress distribution according to the thread design and the marginal bone loss of a single unit dental implant under the axial and offset-axial loading by three dimensional finite element analysis. The implants used had the diameter of 5mm and 4mm with 13mm in length and prosthesis with a conical type which is 6mm in height and 12mm in diameter. The thread designs were triangular, square and buttress. In the three dimensional finite element model with
hexahedron and 2mm cortical thickness, implants were placed with crown to root ratio 7:12, 10:9, 13:6 and 16:3. And additionally the axial force of 100N were applied into 0mm, 2mm and 4mm away from the center of the implants. The results were as follows 1. The maximum von-Mises stress in cortical bone was concentrated to cervical area of implant, and in cancellous bone, apical portion. 2. Comparing the von-Mises stresses in cortical bone of 2mm and 4mm offset loading with central axial loading, it were increased to 3 and 5 times in diameter 4mm implant, and 2 and 4 times, in diameter 5mm implant. 3. The square threads were more effective than the triangular and butress as the longer diameter, the offset loading, and the worse crown to root ratio. 4. The von-Mises stresses were relatively stable until crown to root ratio 13:6, but it was suddenly increased at 16:3. From the results of this study, minimum requirement of crown to root ratio of implant is 2:1, and in the respect of crown to root ratio, diameter and offset loading, square threads are more effective than triangular and buttress threads.
CLINICAL REVIEW OF VARIOUS SURGICAL APPROACHES IN THE TREATMENT OF MANDIBULAR CONDYLE FRACTURE
Kim, Ji-Hyuck ; Kim, Soung-Min ; Kwon, Gwang-Jun ; Park, Young-Wook ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 72~82
Various surgical approaches in the mandibular condyle fracture have been reported and many advantages of intraoral reduction were also introduced. But there are still controversies about surgical method of condylar fractures up to date. To establish the surgical approach protocol of condylar fracture, from May 2001 to December 2004, total 65 patients with 74 fractures of the mandibular condyle were reviewed during 2 years, retrospectively. All cases were classified according to the treatment considering factors, such as the level of fracture, degree and direction of displacement of fractured segment, patient’s age and gender, surgical approach methods, and their complications. Especially, advantages and surgical limitations of extraoral surgical approach, such as direct reduction and fixation via submandibular approach, Nam’s method, and endaural approach, were compared with those of intraoral surgical approach, such as direct intraoral reduction with transbuccal fixation or right angle driver system, and intraoral reinsertional approach after extraoral fixation of fractured fragment. The guidelines of surgical approach of condylar fracture based on our clilnical retrospective experiences and literature reviews can be suggested.
A CLINICAL STUDY ON SUPERIORLY BASED PLATYSMA MYOCUTANEOUS CERVICAL FLAP FOR RECONSTRUCTION FOLLOWING INTRAORAL SOFT TISSUE CANCER SURGERY
Park, Bong-Wook ; Byun, June-Ho ; Shin, Hee-Suk ; Kim, Jong-Ryoul ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 83~91
The goal of reconstruction following ablative therapy for intraoral cancer is the restoration of form and function to permit a return to activities of daily life. Traditional reconstruction includes split thickness skin grafts, myocutaneous flaps and, more recently, various free flaps. Free flaps provide higher level of functional recovery relative to that seen with other techniques but require the complexity of the technique and microvascular anastomosis and thus, extended surgical time and occasionally a second team for harvesting. The platysma myocutaneous cervical flap is a possible alternative for intraoral reconstruction. It is thin and pliable like the tissue provided by the radial forearm free flap. It can be harvested with enough tissue to close most head and neck ablative defects. There is virtually no donor site morbidity involved. This study evaluated 7 patients affected by intraoral squamous cell carcinoma (SCC). All patients underwent the resection of intraoral SCC with neck dissection and subsequent intraoral reconstruction with the superiorly based platysma myocutaneous cervical flap. Flap-related complications occurred in 3 patients. Adjuvant radiation therapy was performed in 3 patients. Average follow-up was 24.1 months after surgery, with a range of 8 to 42 months. All patients presented self assessment of discomfort associated with intraoral recipient sites and cervical donor sites. However, the neck function measured by two-inclinometer technique was within the normal range during relatively long term follow-up period. Our study concluded that superiorly based platysma myocutaneous cervical flap is good alternative to free flaps, especially for relatively smaller defects and for the defects appropriate for the rotation arc of the flap.
MAXILLARY DISTRACTION USING RED SYSTEM : A REVIEW OF 11 CONSECUTIVE CASES
Kim, Jong-Ryoul ; Song, In-Woo ; Kim, Si-Yeob ; Hwang, Dae-Seok ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 92~99
The purpose of this study was to evaluate maxillay distraction for the cleft and other patients who were treated with RED
(Martin, Tuttlingen Germany). Eleven patients with severe maxillary hypoplasia who were treated between 2002 and 2007 in the Department of Oral and Maxillofacial surgery, Pusan National University Hospital, are reviewed for this study. Their age at the time of surgery ranged from 7 to 22 years(mean age=15.36 years). Distraction was started at 5 days after Le Fort I or III osteotomy at a rate of 1mm per day for 10 to 20days. All patients used the Rigid External Distraction II system. After distraction was completed, a 2 to 3 months period of consolidation was undertaken. The follow-up period ranged from 1 to 6 years. The mean amount of advancement of the maxilla was 14.2mm(A-point). Relapse, VPI, and local infection around the halo pin were the most common complications. In adult patients, the relapse of maxilla ranged from 21% to 35%. In the growing child, postoperative stability of the maxilla was unstable and unpredictable.
SURGICAL TREATMENT OF LARGE CYST ON THE MANDIBLE BY USING SAGGITAL SPLIT RAMUS OSTEOTOMY
Park, Hong-Ju ; Ryu, Jae-Young ; Kook, Min-Suk ; Oh, Hee-Kyun ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 100~107
First of all a good surgical access is considered among various approach methods to the cystic lesion. A poor surgical access can lead to a failure of the whole treatment. A sagittal split ramus osteotomy (SSRO) on the large cyst occurring in the mandibular ramus lets us not only reduce operation time, but can additionally contribute to a good visual field. In addition, a merit exists that it lets this operating method provide soft tissue adhesion for proximal and distal segment and decrease post operative necrosis. We experienced three cases of a large cyst on the mandibular angle and ramus. By employing a sagittal splitting of the mandible, it provided good surgical access and operation results without recurrence during a follow-up period. The surgical technique described may be helpful in treating similar large cysts.
VERTICAL ALVEOLAR BONE AUGMENTATION USING THIN BLOCK AND CHIP BONE GRAFT TECHNIQUE : CASE REPORT
Oh, Sung-Hwan ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 108~113
It would be desirable to regenerate bone vertically in a predictable way; such a technique would allow for more favorable implant - crown ratio and better esthetics for implant placement. Traditionally, several techniques has been proposed for this purpose including GBR with particulated bone and block bone graft using mandible or illium however, the efficacy of these techniques has not been firmly established because they have some week points or complications each other that it is difficult to draw firm conclusion for superiority. In recent years, We have treated 11-cases of vertical deficiency of alveolar bone using thin block and chip bone graft technique and the postoperative results showed good prognosis with few complications. So we report the results of its treatment and cases with review of literature.
POSTOPERATIVE MANIC EPISODE BY SLEEP DEPRIVATION AND STRESSFUL EVENT
Kong, Jun-Ha ; Lee, Baek-Soo ; Kim, Yeo-Gab ; Kwon, Yong-Dae ; Yoon, Byung-Wook ; Choi, Byung-Joon ;
Maxillofacial Plastic and Reconstructive Surgery, volume 30, issue 1, 2008, Pages 114~116
Mania in psychiatry describes not only the state of temporary elation of the mood but also of the general mental function such as contents of a thought, thinking process, motivation, enthusiasm, interest, behavior, slumber and physical activities. The time of period when the above changes of mood, mental and behavioral disorder appear is called a manic episode. Postoperative mania is very rare and it has been reported only 5 times in english literature. It's an extremely rare case which has not yet been reported in Oral and Maxillofacial surgery. Patients normally deny the symptoms and it is easy to miss the diagnosis since the patient tends to seem content and happy. Patients show the following initial symptoms of mania - postoperative insomnia, atypical gregariousness, euphoria and unstability. Patients who are not disaffected with insomnia can also be included.