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ABSTRACT: A zygomaticomaxillary complex fracture is a facial bone fracture that commonly occurs as a centrally and laterally protruding zygomatic area. The exact reduction of the displaced fracture is the most important task in the treatment of a zygomatic fracture, from the aesthetic point of view. In some types of zygomaticomaxillary complex fracture, however, it is somewhat difficult to maintain the reduction after the surgery using 3-point fixation. In addition, surgery using 3-point fixation may cause malunion or nonunion. Thus, 4-point fixation using the coronal approach is alternatively considered. The authors performed 4-point fixation using the preauricular approach to counter the disadvantages of the coronal approach. The results and usefulness of 4-point fixation using the preauricular approach are reported in this study.
This study was conducted on 172 patients who had a zygomaticomaxillary complex fracture and an isolated zygomatic arch fracture from March 2010 to September 2011. Open reduction and internal fixation were performed on the patients with a zygomaticomaxillary fracture, and closed reduction using the Gilles technique was performed on the patients with an isolated zygomatic arch fracture, among whom reduction using the preauricular approach was further performed on 17 patients who had insufficient intraoperative reduction or who had unsatisfactory intraoperative radiologic outcomes. An approximately 1.8-cm preauricular incision was made from 1.5 cm anterior to the helical root of the ear to 1 cm anterior to the tragus in a curved shape. After the incision, the temporoparietal fascia was dissected to confirm that the incision had reached the zygomatic arch behind the facture line. The reduction was performed, whereas the displaced fractured bone was being observed with the eyes, followed by the internal fixation. Plane x-ray and 3-dimensional head computed tomography were performed before the surgery, after the surgery, and 6 months after the surgery to examine the reduction status and outcomes of the displaced fracture. The mean follow-up period was 5.5 (range, 5-6) months.
Reduction using the preauricular approach was further performed on 17 patients who showed unsatisfactory reduction among 172 patients with a zygomaticomaxillary complex fracture and an isolated zygomatic arch fracture. Reduction using the preauricular approach was further performed on the displaced fractured site that remained unrepaired in an intraoperative radiologic examination. In the postoperative 3-dimensional head computed tomography and plane x-ray, satisfactory reduction that showed exact correction was observed. In an outpatient follow-up, no complication such as nonunion or malunion was found, and facial symmetry was also shown. In addition, the preauricular scar was hardly observed.
Exact reduction and internal fixation of a fracture site are required to restore the appearance and functions of the normal face and to reduce complications such as malunion or nonunion in patients with a zygomaticomaxillary complex fracture. If a complex fracture of the zygomatic body or facture of the zygomaticomaxillary buttress is accompanied by a fracture of the inferior orbital rim, and thus, if incomplete reduction or malunion is anticipated, 4-point fixation using the easier-to-manipulate preauricular approach would be more useful than the conventional method that uses the coronal approach.
The Journal of craniofacial surgery 03/2013; 24(2):557-62. · 0.81 Impact Factor
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ABSTRACT: In Korean women, many of whom have small to moderate-sized breasts, it is difficult to cover a partial breast defect using oncoplastic volume displacement techniques after removal of an adequate volume of tissue during oncologic surgery. In such cases, oncoplastic volume replacement techniques are more useful.
From January 2007 to December 2011, 104 women underwent a total of 107 breast-conserving surgeries with various kinds of oncoplastic volume replacement techniques. We used latissimus dorsi (LD) myocutaneous flap for cases in which the resection mass was greater than 150 g. In case with a resection mass less than 150 g, we used regional flaps such as a lateral thoracodorsal flap, a thoracoepigastric flap, or perforator flaps such as an intercostal artery perforator (ICAP) flap or a thoracodorsal artery perforator (TDAP) flap.
The mean age was 46.1 years, and the average follow-up interval was 10.3 months. The patients underwent oncoplastic volume replacement techniques with a lateral thoracodorsal flap (n=9), thoracoepigastric flap (n=7), ICAP flap (n=25), TDAP flap (n=12), and LD flap (n=54). There was one case of congestion in an LD flap, and two cases of fat necrosis in an ICAP flap. Most of the patients were satisfied with the cosmetic results.
Oncoplastic volume replacement techniques can be reliable and useful for the correction of breast deformity after breast-conserving surgery, especially in patients with small to moderate-sized breasts.
Archives of plastic surgery. 09/2012; 39(5):489-96.
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ABSTRACT: The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.
Archives of plastic surgery. 07/2012; 39(4):291-300.
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ABSTRACT: In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle.
Archives of plastic surgery. 07/2012; 39(4):301-8.
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ABSTRACT: This article presents long-term outcomes after correcting secondary bilateral cleft lip nasal deformities using a refined reverse-U incision and V-Y plasty or in combination with a composite graft in order to elongate the short columella.
A total of forty-six patients underwent surgery between September 1996 and December 2008. The age of the patients ranged from 3 to 19 years of age. A bilateral reverse-U incision and V-Y plasty were used in 24 patients. A composite graft from the helical root was combined with a bilateral reverse-U incision in the 22 patients who possessed a severely shortened columella. The follow-up period ranged between 2 and 10 years.
A total of 32 patients out of 46 were evaluated postoperatively. The average columella length was significantly improved from an average of 3.7 mm preoperatively to 8.5 mm postoperatively. The average ratio of the columella height to the alar base width was 0.18 preoperatively and 0.29 postoperatively. The postoperative basal and lateral views revealed a better shape of the nostrils and columella. The elongated columella, combined with a composite graft, presented good maintenance of the corrected position with no growth disturbance. A composite graft showed color mismatching in several patients. Twenty-six patients demonstrated no alar-columella web deformity and satisfactory symmetry of the nostrils. Four patients experienced a drooping and overhanging of the corrected alar-columella web.
A bilateral reverse-U incision with V-Y plasty or in combination with a composite graft was effective in correcting secondary bilateral cleft lip nasal deformity.
Archives of plastic surgery. 05/2012; 39(3):190-7.
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ABSTRACT: A new controlled release system is proposed for bone morphogenetic proteins (BMP)-induced osteoblastic growth and differentiation
of the human bone marrow stromal cells (hBMSCs) using injectable nanohydrogels. Alginate nanohydrogels (ANH) containing BMP-2 (BMP-2@ANH) were prepared using a reverse
emulsificationdiffusion technique. The mean particle diameter of the BMP-2@ANH measured by dynamic light scattering was 520
nm. The proliferation of hBMSCs was promoted with the BMP-2@ANH. The controlled release of BMP-2 from the BMP-2@ANH enhanced the differentiation of
hBMSCs into osteoblasts, which was confirmed by RT-PCR and alkaline phosphate activity. With the BMP-2@ANH, calcification and
phosphate deposits on the cells were confirmed by alizarin red-S staining and von-kossa staining, respectively, showing that
the differentiation of hBMSCs into osteoblasts was activated by the BMP-2 released from the BMP-2@ANH. Growth factor delivery using a nanohydrogel
is a potential method for facilitating the differentiation of stem cells in vivo.
Keywordshuman bone marrow stromal cells-alginate nanohydrogel-BMP-2-controlled release-osteogenic differentiation
Macromolecular Research 04/2012; 18(8):787-792. · 1.15 Impact Factor
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ABSTRACT: The synchondrosis between the sixth and seventh costal cartilage is usually used for the base frame in autogenous ear reconstruction. If the synchondrosis is loose, a variety of modifications can be devised. This report introduces new methods for these problems. In cases of incomplete synchondrosis, only the surface of the base block margin was smoothly tapered without carving for the removal of the conchal deepening. The secure fixation of the two segments (helix and antihelix) to the base block using fine wire sutures gave stability to the unstable basal frame. After confirming that all the segments were assembled in one stable piece, the remaining conchal deepening of the basal framework was removed, and the outer lower portion of the basal cartilage was trimmed along its whole length. A total of 10 consecutive patients with microtia, ranging from 8 to 13 years old, were treated from 2008 to 2009. The follow-up period was 6 months to 2 years. Despite incomplete synchondrosis, the stable frameworks were constructed using the authors' method and aesthetically acceptable results were achieved. The proposed method can provide an easy way to make a stable cartilage framework regardless of the variable conditions of synchondrosis.
Archives of plastic surgery. 03/2012; 39(2):162-5.
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ABSTRACT: The epitome that cell carrier serves solely as passive vehicles has become outdated. It is now evident that the carrier microenvironment also contributes in the regeneration process. In this study, a combination of alginate, pluronic F127 and extracellular matrix (ECM) component, hyaluronic acid (HA) based scaffold has been prepared for in situ gelling vehicles for muscle cells. ECM incorporated blended hydrogel showed enhanced uniform distri-bution of muscle cells in a nude mouse model forming the scaffold in situ allowed the muscle cells to proliferate efficiently, indicating that a pluronic F127/alginate/HA matrix provided a beneficial environment for cellular growth and expansion. The formation of gel beneath the skin of nude mice was confirmed using optical coherence tomog-raphy (OCT). OCT has been used to visualize the in situ localization of cells as well. This in situ gelation is found to be advantageous for regenerative applications due to the absence of toxic solvents or co-polymerization agents; besides the handling process is simple. This study demonstrates that an in situ blended hydrogels enables the favor-able settlement of cells and satisfactory cell delivery for muscle regeneration applications.
Tissue Engineering and Regenerative Medicine. 01/2012; 9(1-1).
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ABSTRACT: Soft tissue augmentation with injectable materials has been a challenging problem for plastic and reconstructive surgeons. Although filler materials have been used for soft tissue augmentation, adverse effects such as inflammation, distortion, and repeated procedures due to absorption still exist. In this study, biologic filler containing human fibroblasts and placenta extracts was developed to overcome these problems as a concept of cell therapy.In an in vivo assay, 40 nude mice were divided into 4 groups: 1 control group and 3 experimental groups. Biologic fillers containing human fibroblasts untreated (control), cultured with 0.1% placenta extract (group 1), cultured with 10% fetal bovine serum (group 2), and cultured with both 0.1% placenta extract and 10% fetal bovine serum (group 3) were used in each groups. Cultured human fibroblasts were injected into the back of each mouse with fibrin glue to maintain the shape and volume. These groups were compared during an 8-week period. The gross, histologic, and biomolecular studies were proceeded to evaluate the effect of biologic filler.In geometric maintenance, volumes in experimental groups were 1.6 (group 1), 1.2 (group 2), and 1.9 times (group 3) more reserved than that in the untreated control group (control) at 8 weeks. In histology, abundant proliferation of fibroblasts as well as extracellular matrices including collagen and glycosaminoglycan was visualized in experimental groups. Enzyme-linked immunosorbent assay was used to analyze collagen and glycosaminoglycan, and reverse transcription-polymerase chain reaction was used to analyze the messenger RNA expression of COL1A1, a gene for collagen type 1, which shows a significant difference between control and experimental groups. There is no statistically significant difference between groups 1 and 2; on the other hand, group 3 statistically has the best outcome among the experimental groups.
The Journal of craniofacial surgery 09/2011; 22(5):1557-60. · 0.81 Impact Factor
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ABSTRACT: Cutaneous arteriovenous malformations (AVMs) of stage I may mimic port-wine stains (PWSs) clinicopathologically; therefore, it may be misdiagnosed and mistreated as being PWS.
To suggest the clinicopathological differential clues between early AVMs and PWSs.
A set of 10 radiologically proven AVMs of stage I was selected in conjunction with a set of 10 age-/sex-matched PWSs as a control. Their clinical features, hematoxylin and eosin, CD31, and smooth muscle actin immunohistochemistry were then compared.
Four pathological clues for differential diagnosis with statistical significance (P < 0.05) were found: the vessel density (CD31), presence of vascular luminal red blood cells, elongation and haphazard branching of vessels, and thickened vessel walls highlighted by smooth muscle actin.
Therefore, 4 differential clues with respect to stage I AVM and PWS in their earlier developmental stages have been proposed.
The American Journal of dermatopathology 08/2011; 34(5):523-8. · 1.30 Impact Factor
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ABSTRACT: Excellent colloidal stability and antimicrobial activity are important parameters for silver nanoparticles (AgNPs) in a range of biomedical applications. In this study, polyethyleneimine (PEI)-capped silver nanoparticles (PEI-AgNPs) were synthesized in the presence of sodium borohydride (NaBH(4)) and PEI at room temperature. The PEI-AgNPs had a positive zeta potential of approximately +49 mV, and formed a stable nanocolloid against agglomeration due to electrostatic repulsion. The particle size and hydrodynamic cluster size showed significant correlations with the amount of PEI and NaBH(4). PEI-AgNPs and even PEI showed excellent antimicrobial activity against Staphylococus aureus and Klebsiella pneumoniae. The cytotoxic effects of PEI and PEI-AgNPs were confirmed by an evaluation of the cell viability. The results suggest that the amount of PEI should be minimized to the level that maintains the stability of PEI-AgNPs in a colloidal dispersion.
Colloids and surfaces. B, Biointerfaces 07/2011; 88(1):505-11. · 2.60 Impact Factor
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ABSTRACT: Because the average breast size of Korean women is not as large as that of western women, it is not so easy to apply the oncoplastic volume displacement technique. However, we have tried to use volume displacement techniques that work well with small-breasted women. In this study, we report the usefulness of displacement techniques in the superiorly located cancers with small- to moderate-sized breasts. Between September 2006 and August 2009, 58 women were treated for superiorly located cancers. All patients who were selected had small- to moderate-sized breasts and small to moderate breast defects. They were divided into 3 groups. The groups were split based on the distance from the nipple-areolar complex, which are as follows: near, intermediate, and far. Their mean age was 46 and the average follow-up interval was 21 months. Median weight of the specimen on the tumor side was 84 g (range, 29-140 g). The various surgical techniques used were the "round block" technique (n = 8) and "batwing mastopexy" (n = 4) for near lesions; "tennis racket" method (n = 32) and "rotational flap" (n = 8) for intermediate lesions; and "parallelogram mastopexy lumpectomy" (n = 6) for far lesions. There were 4 complications (nipple-areolar complex partial necrosis, radiation burn, and 2 wound dehiscence). No local recurrences have been observed and a majority of the patients were satisfied with cosmetic results. Oncoplastic volume displacement techniques in superiorly located breast cancers for Korean patients with small- to moderate-sized breast are reliable and should be considered in the case of breast conserving surgery (BCS).
Annals of plastic surgery 02/2011; 67(5):474-80. · 1.29 Impact Factor
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Jae Hoon Choi,
Sang Woo Park, Ho Yun Chung,
Kang Young Choi,
Hyuk Won Chang,
Jun Hyung Kim,
Daegu Son,
Kihwan Han,
Ho-Chan Cho,
Lianji Xu,
Tae Hyun Choi,
Sukwha Kim
Dermatologic Surgery 12/2010; 36 Suppl 4:2188-92. · 1.80 Impact Factor
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ABSTRACT: Deeply-located vascular birthmarks have been traditionally regarded as being identical to a deep type of hemangioma of infancy (HOI). However, there is increasing evidence that some venous malformations also mimic these deep type of HOIs clinically. This study investigates how many, if not all, deep vascular birthmarks are deep type HOIs.
Nineteen cases were selected on the basis of the clinical features of deeply-located vascular birthmarks. Hematoxylin-eosin slides were reviewed and immunohistochemistries were performed using CD31, D2-40 and GLUT1 to confirm diagnoses before they were compared with the clinicoradiologic review by specialists other than dermatopathologists.
Only 4 patients out of a total of 19 cases were strongly positive for GLUT1 staining and turned out to be true deep HOIs. The remaining were comprised of 6 venous malformations (31.6%), 3 lymphatic malformations (15.8%), 1 glomangioma (5.3%) and 5 tufted angiomas (26.3%).
It was demonstrated that all deeply-located vascular birthmarks are not true deep HOIs. It is recommended that diagnosis for HOI be carried out cautiously earlier in life using GLUT1 in addition to clinical features. This would help prevent patients from being misled by anticipating the spontaneous involution in all deeply-located vascular birthmarks.
International journal of dermatology 09/2009; 48(8):817-21. · 1.18 Impact Factor
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Dermatologic Surgery 04/2009; 35(3):546-9. · 1.80 Impact Factor
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ABSTRACT: Although interest in flap surgery has increased, a satisfactory research study on supportive drugs or methods for flap surgery has not been seen in the literature thus far. Despite several studies using botulinum toxin A for flap surgery being reported, their efforts to clarify the mechanisms are not sufficient. Therefore, the authors have studied the effect of botulinum toxin A on random cutaneous flap survival in a rat model under the hypothesis that it affects the microvascular system.
Thirty 10-week-old Sprague-Dawley rats were divided into experimental (n=15) and control groups (n=15). The experimental group used 1.5 IU (International Units) of botulinum toxin A, and the control group used normal saline. A 2x8 cm random cutaneous flap was designed on the rats and then elevated. Normal saline (0.05 cc) and 1.5 IU of botulinum toxin A (0.05 cc) (Botox, Allergan, USA) were injected into the dermis layer of the central portion in the proximal one-third of the flap. Gross photographs were taken at days 1, 3, 5 and 7 after the operation. Laser-induced fluorescein fluoroscopy was performed on postoperative day 7 and tissues were retrieved for histological analysis. In addition, reverse transcriptase polymerase chain reaction (RT-PCR) was carried out for quantitative analysis.
Gross photos and laser-induced fluorescein fluoroscopy reveal the survival rate of the Botox group was 8.3% higher than the control. In the histologic study, the diameter of vessels is larger and the number of immature vessels is more in the Botox group. The result of RT-PCR shows increased expression of VEGF (vascular endothelial growth factor), CD 31 (PECAM1, platelet/endothelial cell adhesion molecule) and iNOS (inducible nitric oxide synthase), which are considered to be related to vasodilation and endothelial proliferation.
Our results suggest that botulinum toxin A increases the survival rate of random cutaneous flaps by means of selective suppression of sympathetic neurons of the cutaneous microcirculation system.
Journal of Plastic Reconstructive & Aesthetic Surgery 05/2008; 62(7):906-13. · 1.49 Impact Factor
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ABSTRACT: Clinical application of the cartilage formed by tissue engineering is not practical due to the failure to maintain long-term tissue structural integrity. One of the important factors for maintaining integrity is the biomaterial for a scaffold. The purpose of the current study was to evaluate the difference between poly-lactic glycolic acid (PLGA) and chitosan as scaffolds. Human auricular chondrocytes were used. Chondrocyte-scaffold complexes were implanted in nude mice and analyzed at 4, 8, 12, 16, and 24 weeks after implantation. The volume of chondrocyte-PLGA complexes decreased rapidly. The volume of chondrocyte-chitosan complexes was well maintained with a slow decrease rate. In histological findings, mature cartilage was formed by 4 weeks in the PLGA group. However, cartilage structure was hardly found after 16 weeks. In the chitosan group, mature cartilage was detected at 8 weeks and cartilage formation became more marked with time. The expression of type II collagen protein and mRNA became weaker with time in the PLGA group. However, the expression in the chitosan group was strong for the whole period. These results suggest that chitosan is a superior scaffold for cartilage tissue engineering in terms of the maintenance of structural integrity. It is expected that after some modification for more rapid chondrogenesis, chitosan scaffolds may become one of the most useful scaffolds for cartilage tissue engineering.
Journal of Craniofacial Surgery 12/2007; 18(6):1249-58. · 0.82 Impact Factor
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ABSTRACT: We divided healthy newborns (aged between 2 weeks and 6 months) into four groups, less than 2 weeks old, 60 +/- 7 days, 120 +/- 7 days, and 180 +/- 7 days, between June 2001 and February 2002, and each group had 40 infants. The lineal distances included 13 items related to the nose, mouth, and lips. The average width of the columella at the midpoint was 3.2, 3.5, 3.7, and 3.8 mm for the 2-week-old group, the 2-month-old group, the 4-month-old group, and the 6-month-old group, respectively. The average height of the columella was 4.7, 4.9, 5.2, and 5.3 mm. The average length between the medial alar bases was 13.7, 14.4, 17.4, and 17.6 mm. The average length from the base to the tip of Cupid's bow was 9.5, 10.0, 10.5, and 10.6 mm. The average length from the columella lateral base to the tip of Cupid's bow was 8.4, 9.9, 10.2, and 10.5 mm. The average length from the columella central base to the center of Cupid's bow was 8.3, 9.5, 9.8, and 9.9 mm. The average width of one limb of Cupid's bow was 2.7, 3.1, 3.4, and 3.5 mm. The average length from the tip of Cupid's bow to the commissure was 13.4, 14.7, 16.4, and 16.9 mm. The average intercommissural distance was 26.8, 30.3, 30.8, and 32.7 mm. The average width of the philtral column at the columella base was 3.1, 3.6, 3.7, and 4.0 mm. The average width of the philtral columns at the mid-portion was 3.7, 4.6, 4.6, and 4.6 mm. The average height of the nasal tip protrusion was 8.7, 11.0, 11.7, and 12.1 mm. The average width of the nose was 20.7, 23.7, 25.3, and 25.9 mm. In conclusion, these data are expected to be useful for patients with a bilateral cleft lip.
Journal of Craniofacial Surgery 02/2006; 17(1):57-61. · 0.82 Impact Factor
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Byung Chae Cho, Ho Yun Chung,
Dong Gul Lee,
Jung Duk Yang,
Jae Woo Park,
Kyung Ho Roh,
Go Un Kim,
Dong Sin Lee,
Ick Chan Kwon,
Eun Hee Bae,
Kwang Ho Jang,
Rang Woon Park,
In San Kim
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ABSTRACT: The purpose of this project was to study the effect of chitosan bead encapsulating calcium sulfate, which provides a sustained release of chitosan and calcium sulfate after implantation, on early bony consolidation in distraction osteogenesis of a dog model.
Forty-five dogs were used for this study. An external distraction device was applied to the mandibular body after a vertical osteotomy and mandibular distraction was initiated 5 days after the operation at a rate of 1 mm/day up to a 10-mm distraction. The experimental group was divided into a control group (I), hyaluronic acid group (II), chitosan group (III), calcium sulfate group (IV), and chitosan bead encapsulating calcium sulfate group (V). Normal saline was injected in group I. In group II, 1 mL of hyaluronic acid solution was injected into the distracted region. In group III, 1 mL of injectable solution of chitosan mixed with hyaluronic acid was implanted. In group IV, 1 mL of injectable solution of calcium sulfate mixed with hyaluronic acid was implanted. In group V, an injectable form of powdered chitosan bead encapsulating calcium sulfate mixed with 1 mL volume of hyaluronic acid was implanted.
Bone mineral density was 12% of the contralateral normal mandible at 3 weeks, 23.4% at 6 weeks in group I, 15% at 3 weeks, 29.1% at 6 weeks in group II, 16% at 3 weeks and 32% at 6 weeks in group III, 30.4% at 3 weeks and 52.8% at 6 weeks in group IV, and 33.6% at 3 weeks and 55% at 6 weeks in group V with statistical significance (P < .005). The mean 3-point failure load was compared with the intact contralateral mandible and noted to be 12% in the control group, 16% in group II, 18% in group III, 34.3% in group IV, and 31.7% in group V. Difference of mean percentages between one group and another was statistically significant (P < .005). In the histologic findings, new bone was generated in all groups. In groups IV and V, the formation of active woven bone was observed throughout the distracted region at 6 weeks. The amount of new bone formation in the distracted zone was in the order of group IV and V, III and II, and the control group.
These findings suggest that chitosan bead encapsulating calcium sulfate appears to facilitate early bony consolidation in distraction osteogenesis.
Journal of Oral and Maxillofacial Surgery 12/2005; 63(12):1753-64. · 1.64 Impact Factor
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Byung Chae Cho,
Tae Gyu Kim,
Jung Duk Yang, Ho Yun Chung,
Jae Woo Park,
Ick Chan Kwon,
Kyung Ho Roh,
Hye Sun Chung,
Dong Sin Lee,
Nang Un Park,
In San Kim
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ABSTRACT: The purpose of this experiment was to study the effects of chitosan, calcium sulfate, and calcium sulfate-chitosan composite pellet on the osteogenesis of defective tibia in rabbits. Eighty New Zealand white rabbits, each weighing approximately 3 to 3.5 kg, were used for this study. A 1-cm ostectomy was made on the middle of the tibia of each rabbit with the periosteum preserved. Nothing was implanted in the control group (group 1), and five chitosan pellets (60 mg/pellet) were implanted in group 1, three OsteoSet pellets (100 mg/pellet) in group 3, and four calcium sulfate-chitosan composite pellets (1 pellet, 80 mg; calcium sulfate 40 mg/pellet, chitosan 40 mg/pellet) in group 4. For each group, a radiographic study, bone mineral density test, three-point bending test, and histologic examination were performed in the second, fourth, and sixth weeks. In the radiologic study, in group 1, cortical bone was not formed even at 6 weeks. In group 2, it was observed at 6 weeks. In groups 3 and 4, cortical bone was partially seen around the fourth week. At 6 weeks, it was clearly observed on both sides, and the projection of the marrow cavity became distinctive, so bone consolidation was considered to be much progressed. The bone mineral density test and three-point bending test results appeared to be highly similar in groups 3 and 4 and in groups 2 and 1. Particularly at 6 weeks, the measures for groups 3 and 4 were statistically significant compared with those for groups 1 and 2 (P < 0.05). In histologic examination, new bone formation began to be seen at 2 weeks in all groups, but it was more active and faster in groups 3 and 4. At 6 weeks, fibrous connective tissue still remained at the center in groups 1 and 2; however, the fibrous connective tissue at the center was replaced with callus, the bony bridge was obvious, and lamellation of callus was observed more in groups 3 and 4. The results indicate that chitosan pellets, OsteoSet, and chitosan-calcium sulfate composite pellets facilitate new bone formation on defected bone, and that particularly OsteoSet and chitosan-calcium sulfate composite pellets are more effective than chitosan.
Journal of Craniofacial Surgery 04/2005; 16(2):213-24; discussion 225-7. · 0.82 Impact Factor
