Comparison of conjunctiva-related complications between scleral and corneal patch grafts in Ahmed glaucoma valve implantation

Purpose: Comparison of the conjunctiva related complication rates and success rates among eyes with Ahmed glaucoma valve (AGV) implantation in which eye bank derived scleral and corneal patch grafts had been used to cover the tube. Methods: Retrospective comparative study. Patients who underwent AGV implantation between January 2000 to December 2016 were included. Demographic, clinical data, intra and post operative data was obtained from electronic medical records. Conjunctiva related complications were divided into two groups: with and without implant exposure. Conjunctiva related complication rates, success rate, risk factors among eyes with corneal and scleral patch graft were compared. Results: Three hundred and twenty three eyes of 316 patients underwent AGV implantation. Scleral patch graft was used in 214 eyes of 210 patients (65.9%) and corneal patch graft was used in 109 eyes of 107 patients (34%). Median follow up was 14 months. There was no significant difference in the conjunctiva related complication rate (7.3 % in corneal patch graft versus 7.0% in scleral patch graft;p=0.5) and conjunctival dehiscence rate (3.7% versus 4.6%, P = 0.7) among the two groups. Success rate was significantly higher in the corneal patch graft group versus the scleral patch graft group (98% versus 72%; p=0.001). Eyes with corneal patch graft had a higher survival rate (P = 0.01). Conclusion: There was no significant difference in the rate of conjunctiva related complications following corneal and scleral patch grafts used to cover the AGV tube. Eyes with corneal patch graft had a higher success rate and survival rate.

Success and survival rate of the implant with crestal sinus lift using S-reamer and gel-type graft material: A retrospective study by more 5-years follow check up / 대한치과보철학회지

PURPOSE: The purpose of this retrospective study was to evaluate the method using the S-reamer and gel-type graft material by the success rate and survival rate.MATERIALS AND METHODS: Implantation period was from 2008 to 2014, Follow check up year is 2019. There were 59 patients and 117 implants. All implants were placed in the posterior maxilla with the sinus lift. The patients population consisted of 34 men and 25 women, ranging from 19 to 75 years. The residual bone heights were from 1 mm to 6 mm. Sinus was perforated with S-reamer without membrane tearing and gel type bone graft material was used for membrane lifting and filling the space. all implants were placed simultaneously. Panoramic X-ray was taken. After 5 – 6 months healing period, final prostheses were restored. After more 5-years implant surgery, Panoramic X-ray was obtained and X-ray analysis and clinical examination were performed. Success criteria was referred to a Buser's success critera. All implants were classified to success implant, survival implant, failed implant. A success implant was satisfying success criteria, a survival implant was a implant that was acute infection with suppuration and bone loss, a failed implant was a implant that was mobile, removed.RESULTS: Five implants were removed, and 4 implants had infected with bone loss. Survival rate was 95.7% and success rate was 92.3%.CONCLUSION: This retrospective study presented that this method with S-reamer and gel-type graft material was a successful treatment without membrane tear in the condition of 1-6 mm residual bone height.

Effect of decompression combined with curettage and autogenous bone cement implantation on large cysts of the jaw / 华西口腔医学杂志

Decompression and curettage can result are effective as treatments for large jaw cysts, which are common diseases in the clinic. Based on a treatment used in a previous study, this paper proposes a "three-step method" to treat large jaw cyst and repair the bone defect by decompression, curettage, and autologous dental bone powder implantation. This paper introduces the processes and key points of the operation involved in the abovementioned method.

Evaluation of the activity of hen eggshell graft in experimentally induced mandibular defects in rabbits: pilot study

Background: For the treatment of the cranial and maxillofacial bone defects autogenic and/or allogenic bone grafts and alloplastic materials have been used for a long time. In the last decade, avian eggshell powder has been suggested as a bone substitute candidate in reconstructive surgery. The purpose of this study was to investigate the beneficial effects of particulate hen eggshell grafting on the healing of experimentally induced mandibular defects.Methods: The study was conducted on 10 adult local rabbits. Two cavities of 4mm diameter have been created in the lateral surface of the mandible. One of the cavities was filled with particulate hen eggshell graft (test one), while the other hole was left for normal healing (control one). On the 8 weeks, the rabbits have been sacrificed and defective regions have been extracted.Results: All animals showed normal wound healing. No foreign body reaction was observed, hen eggshell grafts were resorbed, integrated with bone at 8 weeks.  There were no differences between control and chicken eggshell groups in new bone formation. At 8 weeks, histological analysis of specimens showed different amounts of woven bone contained osteocytes and covered by lining of osteoblasts.Conclusions: Within the limitations of this study, it was concluded that hen eggshell powder is a worth-while bone substitute because it is a safe, cheap, and easily available material.

Assessment of Performance of Cartilage graft in the Management of Chronic Suppurative Otitis Media: A Prospective Study

Introduction: Chronic otitis media (COM) is a long standinginfection of a part or whole of the middle ear cleft. It is oneof the most common ear diseases encountered in developingcountries because of poor socioeconomic standards, poornutrition, lack of health education and unhygienic habits.Perforation of the tympanic membrane(TM) is sequelae ofotitis media and primarily results from middle-ear infection,trauma or iatrogenic causes. The major advantage of cartilagegraft is the stiffness and bradytrophic metabolism. Hence,the aim of the present study was to assess the tolerance,durability and performance of the graft with various thicknessand effectiveness and also to study the acoustic transfercharacteristics of cartilage plates.Material and Methods: This was a prospective study done inthe Department of ENT, GSL Medical College, Rajahmundryfrom September 2016 to august 2018. Patients who were 15-60years of age, with total and subtotal perforations, perforationswith tympanosclerotic plaques, Perforation with atrophicmembranes, Revision surgery for failed myringoplasty ortympanoplasty were selected for the study. Materials usedwere tragal and chonchal cartilage along with an underlaytype I tymponoplasty (primary or revision), using temporalisfascia, tragal cartilage of two different thicknesses was alsoperformed.Results: The graft survival rate with cartilage tympanoplastyis extremely satisfactory (95.2%). There was no significantdifference observed between the graft survival and type ofcartilage used. Hence, both tragal and conchal cartilage canbe used without any predisposition. The hearing results werebetter with cartilage tympanoplasty post-operatively (meanhearing gain 10.57dB).Conclusion: Cartilage is a valuable material for repairing aretracted tympanic membrane because of its stiffness, andcartilage will resist retraction.

Research progress of surgical treatment of thoracolumbar spinal tuberculosis / 中国修复重建外科杂志

Objective: To review the progress of surgical treatment for the thoracolumbar spinal tuberculosis.

Comparative study of new bone formation capability of zirconia bone graft material in rabbit calvarial

PURPOSE: The purpose of this study was to compare the new bone formation capability of zirconia with those of other synthetic bone grafts. MATERIALS AND METHODS: Twelve rabbits were used and four 6-mm diameter transcortical defects were formed on each calvaria. Each defect was filled with Osteon II (Os), Tigran PTG (Ti), and zirconia (Zi) bone grafts. For the control group, the defects were left unfilled. The rabbits were sacrificed at 2, 4, and 8 weeks. Specimens were analyzed through micro computed tomography (CT) and histomorphometric analysis. RESULTS: The Ti and Zi groups showed significant differences in the amount of newly formed bone between 2 and 4 weeks and between 2 and 8 weeks (P < .05). The measurements of total bone using micro CT showed significant differences between the Os and Ti groups and between the Os and Zi groups at 2 and 8 weeks (P < .05). Comparing by week in each group, the Ti group showed a significant difference between 4 and 8 weeks. Histomorphometric analysis also showed significant differences in new bone formation between the control group and the experimental groups at 2, 4, and 8 weeks (P < .05). In the comparison of newly formed bone, significant differences were observed between 2 and 4 weeks and between 2 and 8 weeks (P < .05) in all groups. CONCLUSION: Zirconia bone graft material showed satisfactory results in new bone formation and zirconia could be used as a new synthetic bone graft material.

Clinical Study on the Efficacy of the Autogenous Tooth Bone Graft Material (AutoBT)

Results of Anterior Cruciate Ligament Reconstruction Using Second Look Arthroscopic Examination: Focus on Graft Material and Age / 대한정형외과학회잡지

PURPOSE: We classified patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction into six groups according to graft material and age, and clinical, radiological, and second look arthroscopic results were compared and analyzed. MATERIALS AND METHODS: From January 2006 to December 2009, 57 patients underwent arthroscopic ACL reconstruction and second look arthroscopic examination. We divided patients according to graft materials into the autogenic hamstring tendon group (group 1) and the allogenic tibialis tendon group (group 2), and according to age into three groups (A, B, and C). The mean age at follow-up for second look arthroscopy was 34 years old. Fifty four patients were male and three patients were female, and mean follow-up period was 21.8 months. The result was clinically evaluated using a KT-1000 arthrometer under anesthesia, and the subjective and objective score of International Knee Documentation Committee (IKDC), and radiologically evaluated using the Telos(TM) stress test. We observed graft tension, synovialization and gross findings through a second look arthroscopic examination. RESULTS: The clinical and radiographic results in patients in group 1 and group A showed excellent finding, however, no statistically significant difference was observed. Second look arthroscopic examination in group 1 and group A showed excellent finding. In particular, the formation of synovialization showed excellent finding (50% or more synovialization) in 75% of patients in group 1A who were young and used an autogenic tendon graft, and 45% of patients in group 2C (over 50 years old and allogenic graft), and they were significantly different (p=0.046). There was significant difference in that tension of graft was excellent in group 1A (less than 3 mm). Through the IKDC evaluation method, 93% of cases that showed normal formation of synovialization and 50% of cases that showed inadequate formation of synovialization showed 'like normal' abnormality, so that was correlation was observed between synovialization and IKDC evaluation (p=0.001). CONCLUSION: Patients who used autogenic hamstring tendon and who were young showed excellent synovial membrane formation. In the old age group, autogenous graft will be more optimal.

Clinical evaluation of ridge augmentation using autogenous tooth bone graft material: case series study

OBJECTIVES: Interest in bone graft material has increased with regard to restoration in cases of bone defect around the implant. Autogenous tooth bone graft material was developed and commercialized in 2008. In this study, we evaluated the results of vertical and horizontal ridge augmentation with autogenous tooth bone graft material. MATERIALS AND METHODS: This study targeted patients who had vertical or horizontal ridge augmentation using AutoBT from March 2009 to April 2010. We evaluated the age and gender of the subject patients, implant stability, adjunctive surgery, additional bone graft material and barrier membrane, post-operative complication, implant survival rate, and crestal bone loss. RESULTS: We performed vertical and horizontal ridge augmentation using powder- or block-type autogenous tooth bone graft material, and implant placement was performed on nine patients (male: 7, female: 2). The average age of patients was 49.88+/-12.98 years, and the post-operative follow-up period was 35+/-5.31 months. Post-operative complications included wound dehiscence (one case), hematoma (one case), and implant osseointegration failure (one case; survival rate: 96%); however, there were no complications related to bone graft material, such as infection. Average marginal bone loss after one-year loading was 0.12+/-0.19 mm. Therefore, excellent clinical results can be said to have been obtained. CONCLUSION: Excellent clinical results can be said to have been obtained with vertical and horizontal ridge augmentation using autogenous tooth bone graft material.

Treatment of Endo - Perio Lesion With Syringeable Bio Active Alloplastic Bone Graft Material : A Case Report.

Endodontic–periodontal lesions present challenges to the clinician as far as diagnosis andprognosis of the involved teeth are concerned. Etiologic factors such as bacteria, fungi,and viruses as well as various contributing factors such as trauma, root resorptions,perforations, and dental malformations play an important role in the development andprogression of such lesions. The relationship between the pulp and periodontium has been extensively studied. The pathways for the spread of bacteria between pulpal and periodontal tissues have been discussed with controversy. This case report presents a successful treatment of a 43 year old systemically healthy male suffering with endoperio lesions of upper right first and second molar teeth.

Bone graft material using teeth

Autogenous tooth bone graft material contains organic and inorganic components for osteoinductive and osteoconductive healing. The clinical availability and safety of this material have been confirmed by various experimental and clinical studies. In the future, allogenic and xenogenic tooth bone graft materials, ideal scaffold using teeth for stem cells and bone growth factors, and endodontic and tooth restorative material will be developed.

Long-Term Incidence and Predicting Factors of Cranioplasty Infection after Decompressive Craniectomy

OBJECTIVE: The predictors of cranioplasty infection after decompressive craniectomy have not yet been fully characterized. The objective of the current study was to compare the long-term incidences of surgical site infection according to the graft material and cranioplasty timing after craniectomy, and to determine the associated factors of cranioplasty infection. METHODS: A retrospective cohort study was conducted to assess graft infection in patients who underwent cranioplasty after decompressive craniectomy between 2001 and 2011 at a single-center. From a total of 197 eligible patients, 131 patients undergoing 134 cranioplasties were assessed for event-free survival according to graft material and cranioplasty timing after craniectomy. Kaplan-Meier survival analysis and Cox regression methods were employed, with cranioplasty infection identified as the primary outcome. Secondary outcomes were also evaluated, including autogenous bone resorption, epidural hematoma, subdural hematoma and brain contusion. RESULTS: The median follow-up duration was 454 days (range 10 to 3900 days), during which 14 (10.7%) patients suffered cranioplasty infection. There was no significant difference between the two groups for event-free survival rate for cranioplasty infection with either a cryopreserved or artificial bone graft (p=0.074). Intergroup differences according to cranioplasty time after craniectomy were also not observed (p=0.083). Poor neurologic outcome at cranioplasty significantly affected the development of cranioplasty infection (hazard ratio 5.203, 95% CI 1.075 to 25.193, p=0.04). CONCLUSION: Neurologic status may influence cranioplasty infection after decompressive craniectomy. A further prospective study about predictors of cranioplasty infection including graft material and cranioplasty timing is necessary.

Guide bone regeneration using autogenous teeth: case reports

The authors installed implants combined with guided bony regeneration (GBR) using autogenous tooth bone graft material in the patients. In one patient, GBR and simultaneous implant placement were performed. In two patients, GBR was performed and the implants were placed after 6 months. All patients achieved favorable clinical outcomes. Excellent osteoconductive bony healing was observed in the 6 month histology examination after the bone graft.

The clinical effects of Calcium Sulfate combined with Calcium Carbonate in treating intrabony defects / 대한치주과학회지

PURPOSE: If bone grafts and guided tissue regeneration are effective individually in treating osseous defects, then the question is, what would happen when they are combined. Bone grafts using Calcium Carbonate(Biocoral) and Guided Tissue Regeneration using Calcium Sulfate(CALMATRIX) will maximize their advantages and show the best clinical results in intrabony defects. This study was to compare the effects of a combination of CS and CC with control treated only with modified widman flap in a periodontal repair of intrabony defects. MATERIALS AND METHODS: 30 patients with chronic periodontitis were used in this study. 10 patients were treated with a combination of CS and CC as the experimental groupII and another 10 patients were treated with CC as the experimental groupI, and the remaining 10 patients, the control group were treated only with modified widman flap. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded 6 months later. RESULTS: The probing depth changes were 3.30+/-1.34 mm in the control group, 4.2+/-1.55 mm in the experimental groupI(CC) and 5.00+/-1.33 mm in the experimental groupII(CS+CC). They all showed a significant decrease 6 months after surgery(p <0.01). There was a significant difference(p <0.05) between the control and experimental group. However there were no significant difference(p <0.05) between the experimental groupIand II. The gingival recession changes w -1.30+/-1.25 mm in the control group, This is a significant difference(p <0.01). However, there was a -0.50+/-0.53 mm change in the experimental groupI(CC) and -0.60+/-0.97 mm in the experimental groupII(CS+CC). In addition, in terms of gingival recession, there was a no significance difference(p <0.05) among the groups. The clinical attachment level changes were 2.00+/-1.33 mm in the control group, 3.60+/-1.58 mm in the experimental groupI(CC) and 4.40+/-1.17 mm in the experimental groupII(CS+CC). They all showed a significant decrease 6 months after surgery(p <0.01). There was a significant difference(p <0.05) between the control and experimental group. However there was a no significance difference(p <0.05) between the experimental groupI andII. The bone probing depth changes were 0.60+/-0.52 mm in the control group, 3.20+/-1.48 mm in the experimental groupI (CC) and 4.60+/-1.43 mm in the experimental groupII(CS+CC). All of them showed a significant decrease 6 months after surgery(p <0.01), there was a significance difference(p <0.05) among the groups. CONCLUSION: Treatment using a combination of CS and CC have a potential to improve periodontal parameters in intrabony defects and More efficient clinical results can be expected in intrabony defects less than 2 walls grafted with CS and CC.

Radiographic evaluation of infra-bony defects treated by bone graft procedures / 대한치주과학회지

PURPOSE: A number of techniques and materials have been used for periodontal regeneration and bone graft procedures with guided tissue regeneration(GTR) have been suggested as alternatives to osseous surgery in the management of local infra-bony defects. However, the long-term stability and treatment outcome following bone graft procedure of infra-bony defects is poorly documented. The purpose of this study was to assess radiographic change in infra-bony defects over 2 years after bone graft procedures with various graft materials. MATERIAL AND METHODS: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients showed clinical and radiographic evidence of infra-bony defect(s). 44 sites of 34 patients aged 31 to 69 (mean age 48.3) were treated by bone graft procedure with a bone graft material. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. RESULT: We observed 1.15+/-1.95 mm of bone fill, 0.40+/-1.19 mm of crestal resorption, 1.55+/-1.77 mm of defect resolution, and 40+/-44% of percentage of defect resolution. Deeper initial defect depth, narrower initial defect angle showed significantly greater bone fill, defect resolution, and % of defect resolution. But no significant difference was observed in graft sites and graft materials. CONCLUSION: If good oral hygiene maintenance and periodic recall check of patients is assured, bone graft procedure using various graft materials is one of the appropriate treatment modality for regenerative therapy of infra-bony defects.

Usefulness of acellular dermal matrix graft on the tissue regeneration in rabbits

PURPOSE: The present study was aimed to examine the effect of acellular dermal matrix (AlloDerm(R)) grafted to the experimental tissue defect on tissue regeneration. MATERIALS AND METHODS: Male albino rabbits were used. Soft tissue defects were prepared in the external abdominal oblique muscle. The animals were then divided into 3 groups by the graft material used: no graft, autogenous dermis graft, and AlloDerm(R) graft. The healing sites were histologically examined at weeks 4 and 8 after the graft. In another series, critical sized defects with 8-mm diameter were prepared in the right and left iliac bones. The animals were then divided into 5 groups: no graft, grafted with autogenous iliac bone, AlloDerm(R) graft, AlloDerm(R) graft impregnated with rhBMP-2, and AlloDerm(R) graft with rhTGF-beta(1). The healing sites of bone defect were investigated with radiologic densitometry and histological evaluation at weeks 4 and 8 after the graft. RESULTS: In the soft tissue defect, normal healing was seen in the group of no graft. Inflammatory cells and foreign body reactions were observed in the group of autogenous dermis graft, and the migration of fibroblasts and the formation of vessels into the collagen fibers were observed in the group of AlloDerm(R) graft. In the bone defect, the site of bone defect was healed by fibrous tissues in the group of no graft. The marked radiopacity and good regeneration were seen in the group of autogenous bone graft. There remained the traces of AlloDerm(R) with no satisfactory results in the group of AlloDerm(R) graft. In the groups of the AlloDerm(R) graft with rhBMP-2 or rhTGF-beta(1), there were numerous osteoblasts in the boundary of the adjacent bone which was closely approximated to the AlloDerm(R) with regeneration features. However, the fibrous capsule also remained as in the group of AlloDerm(R) graft, which separated the AlloDerm(R) and the adjacent bone. CONCLUSIONS: These results suggest that AlloDerm(R) can be useful to substitute the autogenous dermis in the soft tissue defect. However, it may not be useful as a bone graft material or a carrier, since the bone defect was not completely healed by the bony tissue, regardless of the presence of osteogenic factors like rhBMP-2 or rhTGF-beta(1).

Usefulness of acellular dermal matrix graft on the tissue regeneration in rabbits

PURPOSE: The present study was aimed to examine the effect of acellular dermal matrix (AlloDerm(R)) grafted to the experimental tissue defect on tissue regeneration. MATERIALS AND METHODS: Male albino rabbits were used. Soft tissue defects were prepared in the external abdominal oblique muscle. The animals were then divided into 3 groups by the graft material used: no graft, autogenous dermis graft, and AlloDerm(R) graft. The healing sites were histologically examined at weeks 4 and 8 after the graft. In another series, critical sized defects with 8-mm diameter were prepared in the right and left iliac bones. The animals were then divided into 5 groups: no graft, grafted with autogenous iliac bone, AlloDerm(R) graft, AlloDerm(R) graft impregnated with rhBMP-2, and AlloDerm(R) graft with rhTGF-beta(1). The healing sites of bone defect were investigated with radiologic densitometry and histological evaluation at weeks 4 and 8 after the graft. RESULTS: In the soft tissue defect, normal healing was seen in the group of no graft. Inflammatory cells and foreign body reactions were observed in the group of autogenous dermis graft, and the migration of fibroblasts and the formation of vessels into the collagen fibers were observed in the group of AlloDerm(R) graft. In the bone defect, the site of bone defect was healed by fibrous tissues in the group of no graft. The marked radiopacity and good regeneration were seen in the group of autogenous bone graft. There remained the traces of AlloDerm(R) with no satisfactory results in the group of AlloDerm(R) graft. In the groups of the AlloDerm(R) graft with rhBMP-2 or rhTGF-beta(1), there were numerous osteoblasts in the boundary of the adjacent bone which was closely approximated to the AlloDerm(R) with regeneration features. However, the fibrous capsule also remained as in the group of AlloDerm(R) graft, which separated the AlloDerm(R) and the adjacent bone. CONCLUSIONS: These results suggest that AlloDerm(R) can be useful to substitute the autogenous dermis in the soft tissue defect. However, it may not be useful as a bone graft material or a carrier, since the bone defect was not completely healed by the bony tissue, regardless of the presence of osteogenic factors like rhBMP-2 or rhTGF-beta(1).

A histological study on several implants for augmentation rhinoplasty in mouse calvarium

The effect of early membrane exposure on exophytic bone formation using perforated titanium membrane / 대한치주과학회지

This study was performed to evaluate the effect of membrane exposure on new bone formation when guided bone regeneration with perforated titanium membrane on atrophic alveolar ridge. The present study attempted to establish a GBR model for four adult beagle dog premolar. Intra-marrow penetration defects were created on the alveolar ridge(twelve weeks after extraction) on the mandibular premolar teeth in the beagle dogs. Space providing perforated titanium membrane with various graft material were implanted to provide for GBR. The graft material were demineralized bovine bone(DBB), Irradiated cancellous bone(ICB) and demineralized human bone powder(DFDB). The gingival flap were advanced to cover the membranes and sutured. Seven sites experienced wound failure within 2-3weeks postsurgery resulting in membrane exposure. The animals were euthanized at 4 weeks postsurgery for histologic and histometric analysis.2) The results of this study were as follows: 1. There was little new bone formation at 4 weeks postsurgery, irrespectively of membrane exposure. 2. There was significant relationship between membrane exposure and bone graft resorption(P< 0.05), but no relation between membrane exposure and infiltrated connective tissue. 3. There was much bone graft resorption on DFDB than ICB and DBB. 4. The less exposure was on the perforated titanium membrane, the more dense infiltrated connective tissue was filled under the membrane when grafted with ICB and DBB. but there was no relationship between the rate of membrane exposure and the percentage of infiltrated connective tissue area and no relationship between the percentage of the area in the infiltrated connective tissue and in the residual bone graft. Within the above results, bone formation may be inhibited when membrane was exposed and ICB and DBB were more effective than DFDB as a bone graft material when guided bone regeneration.