PURPOSE: Platelet Rich Plasma(PRP) application is increasing with sinus inlay bone graft, but there is few research with radiographic ananlysis on effect of PRP in maxillary sinus. The author investigated the amount of bony changes of maxillary sinus for dental implantation among the patients with maxillary inlay graft. MATERIALS AND METHODS: With 10 patients who were treated with sinus inlay autologous bone grafting combined with PRP technique, and with 5 patients who were treated with sinus inlay grafting only without PRP, the panoramic radiographys which were taken at preoperation, immediate postoperation, 3months postoperation, and 4 months postoperation(a month after dental implantation)periods were analysed. The films had been scanned, and then proceeded throughout image analysis system. The bone density of maxillary grafted sites was compared with adjacent tooth enamel density and remeasured according to density luminosity of each film. The density changes on PRP group and bone graft only group were an lysed with non-parameteric statistics method. RESULTS: In PRP combined patients group, bone density on postoperation periods was increased totally. The remarkable enhanced change of bone density was observed on 3 months postoperation period, thereafter the increasing rate was slightly reduced . In only bone graft patients group, bone density on postoperation periods was also increased compared with preoperation period, but the bone density of 4 months postoperation period was decreased compared with 3 months postoperation period. The amount of bone density on PRP group was significantly changed according to periods in contrast to bone graft only group. CONCLUSION: The bone density on PRP group was remarkably increased at 3 months postoperation compared to bone graft only group and it was seemed to be associated with more new bone formation, less grafted bone resorption at bone grafted sites with PRP.
Blood Platelets* ; Bone Density ; Bone Resorption ; Bone Transplantation ; Dental Enamel ; Dental Implantation ; Dental Implants ; Humans ; Inlays ; Maxillary Sinus ; Osteogenesis ; Platelet-Rich Plasma ; Tooth ; Transplants

There are various surgical methods for reconstruction of the nasal defect. Among them, there is some difference in the choosing the proper reconstruction method according to defect size and position. When the defect involved the tip, the columella, and the alar, the local flaps may be preferred, because they can provide sufficient amount of tissue. However, the composite grafts from the ear have been effectively used in reconstructions of smaller sized defects of the columella and ala. We excised total external nose because of squamous cell carcinoma on the nasal tip, columella, and nasal septum. We reconstructed the nasal tip, both alae, and columella with forehead flap. After division of the regional flap, we found partial necrosis of the columella and narrowness of the nostril. So, we used chondrocutaneous auricular composite grafts for reconstruction of the columella and both nostrils. We used the file-folder designed auricular composite graft for reconstruction of columella and the wedge shaped ear helical composite grafts for widening of nostrils. 6 months later, there were no significant problems, except some mismatched dark color in the grafted alar tissues. Here, we report a successful reconstruction of large nasal defect using combined two different reconstructive methods.
Carcinoma, Squamous Cell ; Ear ; Forehead* ; Nasal Septum ; Necrosis ; Nose* ; Transplants*

PURPOSE: The purpose of this study is to observe the salivary immunoglobulin level in whole saliva of infected patients and also to investigate the changes of immunoglobulin level according to its management. MATERIALS AND METHODS: Thirty infected patients who have been admitted to the dept. of oral and maxillofacial surgery of Pusan National University Hospital have been selected as subjects and we analysed the changes of immunoglobulin level of 1.5~3.0ml of unstimulated whole saliva collected throughout four times; the day before treatment, the first day after treatment, the third day after treatment and the day before discharge. We also compared them with immunoglobulins in whole saliva that was collected from 4 normal persons as control group. In radial immunodiffusion technique with BACKMAN(Array 360 system, McLean, USA), level of immunoglobulins was analyzed. RESULTS: The isotypes of Ig that have been found in saliva of normal persons were IgG, IgA, IgM and IgE and their mean level was 8.23, 36.41, 4.38, and 2.38 respectively. In the infected patients before the treatment, the level of IgG, IgA was remarkably higher than that of normal persons, however we could not find the difference on the level of IgM, IgE. As the infection was healing, the level of IgG, IgA was decresing significantly.
Busan ; Humans ; Immunodiffusion ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin Isotypes* ; Immunoglobulin M ; Immunoglobulins* ; Saliva* ; Surgery, Oral

Adult ; Cicatrix ; Dentition ; Follow-Up Studies ; Head ; Humans ; Mandibular Condyle ; Mouth ; Neck ; Open Bite ; Prognosis ; Retrospective Studies ; Surgery, Oral

Fabella impingement syndrome after total knee arthroplasty (TKA) is a rare condition. However, the location of the inserted prosthesis and the size of the fabella are considered major causative factors. Thus far, a conventional surgical excision of the impinged fabella is recommended treatment for the impingement. A 72-year-old woman was diagnosed with degenerative arthritis of the knee. She complained of fabella impingement due to an incompletely excised bony spur behind the posterolateral femoral prosthesis after TKA. The fabella and remaining bony spur were removed using an arthroscopic procedure. The impingement has not recurred and the range of motion (ROM) of the knee was improved after a 12 months follow-up. Arthroscopic surgery might be an alternative treatment for fabella impingement after TKA.
Aged ; Arthroplasty* ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Prostheses and Implants ; Range of Motion, Articular

Cicatrix ; Cleft Lip ; Congenital Abnormalities ; Diagnosis ; Humans ; Lip ; Nose ; Skin

Adult ; Ankylosis ; Arthroplasty ; Follow-Up Studies ; Head ; Humans ; Maxillary Artery ; Mouth ; Spondylitis, Ankylosing ; Temporomandibular Joint

BACKGROUND: Despite the development of progressive surgical techniques and antibiotics, osteomyelitis is a big challenge for orthopedic surgeons. The main aim of this study is to fabricate an in situ gelling hydrogel that permits sustained release of antibiotic (for control of infection) and growth factor (for induction of new bone formation) for effective treatment of osteomyelitis. METHODS: An in situ gelling alginate (ALG)/hyaluronic acid (HA) hydrogel containing vancomycin (antibiotic) and bone morphogenetic protein-2 (BMP-2; growth factor) was prepared by simple mixing of ALG/HA/Na₂HPO₄ solution and CaSO₄/vancomycin/BMP-2 solution. The release behaviors of vancomycin and BMP-2, anti-bacterial effect (in vitro); and therapeutic efficiency for osteomyelitis and bone regeneration (in vivo, osteomyelitis rat model) of the vancomycin and BMP-2-incorporated ALG/HA hydrogel were investigated. RESULTS: The gelation time of the ALG/HA hydrogel was controlled into approximately 4 min, which is sufficient time for handling and injection into osteomyelitis lesion. Both vancomycin and BMP-2 were continuously released from the hydrogel for 6 weeks. From the in vitro studies, the ALG/HA hydrogel showed an effective anti-bacterial activity without significant cytotoxicity for 6 weeks. From an in vivo animal study using Sprague-Dawley rats with osteomyelitis in femur as a model animal, it was demonstrated that the ALG/HA hydrogel was effective for suppressing bacteria (Staphylococcus aureus) proliferation at the osteomyelitis lesion and enhancing bone regeneration without additional bone grafts. CONCLUSIONS: From the results, we suggest that the in situ gelling ALG/HA hydrogel containing vancomycin and BMP-2 can be a feasible therapeutic tool to treat osteomyelitis.
Animals ; Anti-Bacterial Agents ; Bacteria ; Bone Regeneration ; Femur ; Hydrogel ; In Vitro Techniques ; Orthopedics ; Osteomyelitis ; Rats ; Rats, Sprague-Dawley ; Surgeons ; Transplants ; Vancomycin

Adult ; Animals ; Dogs ; Electric Stimulation ; Humans ; Latency Period (Psychology) ; Osteogenesis ; Osteogenesis, Distraction ; Osteopontin ; Osteotomy

The coexistence of aspergillosis and squamous cell carcinoma (SCC) in the maxillary sinus was very rare. To our knowledge, this is the second report of coexistent SCC and aspergillosis in the maxillary sinus. A 58-year-old man underwent surgery for unilateral maxillary sinus infection with oroantral fistula. In the surgical specimen, SCC and aspergillosis were co-detected with routine and immunohistochemical stainings. Moreover, human papillomavirus 18 (HPV-18) was detected by polymerase chain reaction in the sinus specimen. The patient was re-operated with subtotal maxillectomy and has been followed up for two years without any evidence of recurrence or metastasis. Although it is not understood how aspergillosis could induce carcinoma formation, the chronic inflammation caused by prolonged fungal infection might be carcinogenic. Moreover, HPV-16 and -18 were another causative pathogens of SCC in the head and neck region. We recommend careful examination, including preoperative cytology, in patients with maxillary sinus fungal infections because of the potential for cancer development.
Aspergillosis ; Carcinoma, Squamous Cell ; Head ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans ; Inflammation ; Maxillary Sinus ; Middle Aged ; Neck ; Neoplasm Metastasis ; Oroantral Fistula ; Polymerase Chain Reaction ; Recurrence