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Min-Jeong Kwoen,Yong-Hoon Choi,Keun-Suh Kim,Na-Hee Chang,Young-Kyun Kim,Hyo-Jung Lee 대한구강악안면외과학회 2021 대한구강악안면외과학회지 Vol.47 No.2
Objectives: Hyaluronoglucosaminidase (hyaluronidase) increases the local intercellular permeability of the peripheral lymphatic channel and capillaries, which may help reduce edema. In the present study, the effects of hyaluronidase on postoperative edema and pain reduction were evaluated. Materials and Methods: The study included 38 patients who underwent guided bone regeneration (GBR) surgery before implantation. Patients were randomly assigned to either the control group (n=20) or the test group (n=18). Hyaluronidase was injected into the GBR site of subjects in the test group. Postoperative edema was evaluated by measuring the distance between specific facial landmarks immediately after surgery (T1) and 2-4 days after surgery (T2). The degree of pain at T2 and at 10-14 days after surgery (T3) was assessed. Results: In the test group, the degree of swelling was lower than in the control group, however, only two measurements, from the tragus to the mouth corner and from the outer canthus to the mouth corner, showed statistically significant differences (P=0.012 and P=0.001, respectively). The antiedema effect of hyaluronidase was more effective in the maxilla than in the mandible. In the maxilla, the percentage of facial swelling was significant for three measurements. However, in the mandible, the percentage of facial swelling was significant for only one measurement. Low levels of pain that were similar at T2 and T3 were reported in both groups. Conclusion: The results indicate the degree of swelling was lower in the test group and hyaluronidase appeared to be more effective in the maxilla. The degree of pain reduction was similar between groups. Further in vivo and randomized controlled trials with larger sample sizes are warranted.
The use of acellular allogenic dermal matrix in soft tissue management around the implants
Min-Jeong Kwoen,Sang-Yun Kim,Yong-Hoon Choi,Young-Kyun Kim 대한치과이식임플란트학회 2019 The Korean Academy of Implant Dentistry Vol.38 No.1
Purpose: The purpose of this study was to introduce various strategies to deal with soft tissue using an acellular allogenic dermal matrix and to evaluate postoperative complications and implant prognosis (success rate, survival rate, failure, and marginal bone loss). Materials and Methods: This retrospective study investigated 28 patients who had intraoral surgery using an acellular allogenic dermal matrix (Megaderm, L & C BIO Inc, Seoul, Korea) from May 2013 to December 2017. Vestibuloplasty, increasing keratinized mucosa, soft tissue augmentation, and barrier membrane for bone graft were used as surgical methods in 32 cases. Megaderm was applied to nine cases for barrier membrane after guided bone regeneration and 22 cases for soft tissue treatment. One case was used for bone graft and soft tissue treatment. A total of 48 implants were placed. Results: Among the 48 implants, 25 were counted to measure the success rate because more than a year has passed since the placement of prosthetic devices, and radiographic examination was performed. Three implants had peri-implantitis and was classified as failures. Of the 25 implants, 22 (88%) were successful. As none of implants were removed from the placement site, the survival rate was 100%. Conclusions: Megaderm is a biocompatible material which maintains its collagen structure after the manufacturing process. As a result, it acts as a membrane and graft soft tissue material properly in the intraoral environment.