PURPOSE:To investigate the effect of lingual wedge shaped coronectomy in extraction of horizontally impacted mandibular third molar(HIMTM).METHODS:A total of 172 patients with HIMTM were randomly divided into experimental group and routine group with 86 cases in each group . Lingual wedge-shaped coronectomy was applied in the experimental group and T-shaped coronectomy was applied in routine group. Operation time, intraoperative and postoperative complications were compared between the two groups.The data were analyzed by using SPSS 26.0 software package.RESULTS:The operation time of the experimental group was significantly shorter than that of the control group (P＜0.05). The rate of swelling, pain, lingual bone plate injury and broken root of the experimental group were separately lower than that of the control group, and the difference was statistically significant(P＜0.05).CONCLUSIONS:Lingual wedge shaped coronectomy of HIMTM has significant advantages in the extraction of HIMTM. It can reduce operation time，broken roots,fracture of lingual plate, postoperative swelling, pain and other surgical complications.

Objective To compare the efficiency of four methods that remove calcium hydroxide in root canals and to guide clinical practice. Methods Sixty-five isolated mandibular single root canal premolars were collected. After crown cutting and root canal preparation, a tooth was randomly selected as the blank control group, and the remaining 64 teeth were equally divided into Groups A and B (n = 32). Group A was injected with water-soluble calcium hydroxide, and Group B was injected with oil-soluble calcium hydroxide. After 2 weeks of drug sealing, Groups A and B were randomly divided into 4 groups (n = 8), including the lateral opening syringe group, sonic vibration group, ultrasonic group, and Er: YAG laser group. Before and after calcium hydroxide removal, the samples were scanned by cone-beam CT, and the data were imported into Mimics for 3D reconstruction. The root canal was divided into the following segments: superior root segment, middle and apical, and the calcium hydroxide volume of each segment of the root canal was calculated. The volumes of calcium hydroxide before and after removal were V1 and V2, respectively, with a clearance rate = (V1-V2)/V1×100%. Three-factor ANOVA was used for statistical analysis. After Groups A and B were reconstructed, the apical region with residual calcium hydroxide was selected, and the blank control was observed by scanning electron microscopy (SEM). Results Two types of calcium hydroxide could not be completely removed by the four flushing methods. The clearance rate of water-soluble calcium hydroxide was higher than that of oil-soluble calcium hydroxide (P<0.001). Among the three segments of the root canal, the clearance rate of the apical segment was lower (P<0.05). The Er: YAG laser treatment group showed the highest removal efficiency of two kinds of calcium hydroxide, which was higher than that of the other groups, especially in apical of the root. Compared with the sonic wave washing group and the syringe washing group, the ultrasonic wave washing group exhibited significant advantages (P<0.05). The clearance rate of the sonic wave washing group was higher in the oily calcium hydroxide root middle group than in the syringe washing group (P<0.05). SEM showed that the two kinds of calcium hydroxide could not be completely removed, but the residual rate of oil-soluble calcium hydroxide was large. Conclusion Both types of calcium hydroxide could not be completely removed, and compared to water-soluble calcium hydroxide, oil-soluble calcium hydroxide was more difficult to remove. Among the four cleaning methods, Er:YAG laser swing washing showed the higher cleaning efficiency.

BackgroundPatients with hepatocellular carcinoma are often affected by metastases, but condylar metastasis is particularly rare.Case presentationA 51-year-old man with a history of hepatocellular carcinoma requested treatment for facial pain. Computed tomography indicated that the condylar bone has been destroyed and fractured. Pathology confirmed condylar metastasis from hepatocellular carcinoma. Complete metastasectomy and condylar reconstruction were performed to preserve his facial appearance. No local recurrence or distant metastasis was found at 8 months of follow-up.ConclusionThe condyle can be a metastatic site of hepatocellular carcinoma, regardless of its rarity. Long-term comprehensive surveillance and follow-up are needed for patients with hepatocellular carcinoma. The presence of solitary mass does exclude the possibility of metastatic cancer for these patients, and postoperative imaging and pathological diagnosis are important to determine its origin. If patients’ physical condition permits, the mass can be completely excised, and the physiological function can be restored and reconstructed.

目的:评价根管形态、根管充填方法、根管封闭剂三种因素对桩道预备后根管的根尖封闭性的影响.方法:本实验共选取45颗规则的直根管牙根及40颗椭圆形根管牙根,分为9组.其中实验组A组为规则的直根管,A1.iRoot SP+热牙胶(n=10),A2.iRoot SP+单尖法(n=10),A3:GuttaFlow2+热牙胶(n=10),A4:GuttaFlow2+单尖法(n=10);实验组B组为椭圆形根管,Bl:iRoot SP+热牙胶(n=10),B2:iRoot SP+单尖法(n=10),B3:GuttaFlow2+热牙胶(n=10),B4.GuttaFlow2+单尖法(n=10);C组为空白对照组,规则的直根管,不作充填(n=5).实验组充填结束后均行纤维桩桩道预备.使用染料渗透技术评价根尖微渗漏情况,通过扫描电镜观察各组牙本质与根管封闭剂界面的微观形态.结果:A1、A2、A3、A4、B1、B2、B3、B4组分别为(2.97±0.89)、(2.93±1.36)、(0.98±0.68)、(0.99±0.73)、(3.20±1.08)、(3.26±1.17)、(1.10±0.85)、(1.04±0.97)mm,C组渗透根管全长.对结果进行三因素析因设计资料的方差分析显示,根管形态及根管充填方法对根尖封闭性的影响无统计学意义(P＞0.05),根管封闭剂对根尖封闭性有显著影响(P＜0.05).扫描电镜观察,使用GuttaFlow2组封闭剂与根管壁的结合较为紧密.结论:对于桩道预备后的根管,根管封闭剂是影响根尖封闭性的主要因素,GuttaFlow2略优于iRoot SP.根管形态、根管充填方法及根管封闭剂三者之间不存在交互作用.

PURPOSE:To observe the effect of dynamic nutrition support on postoperative energy metabolism, immune function and stress response in patients with oral and maxillofacial tumors.METHODS:Fifty-six patients with oral and maxillofacial tumor surgery were randomly divided into experimental group and control group (28 in each group). Patients in the experimental group received dynamic enteral and parenteral nutrition support according to the stress period after surgery, ω-3 fish oil fat milk injection and glutamine were added in the nutrition support program. Patients in the control group were given routine postoperative enteral and parenteral camp support. Energy metabolism, immune function and stress indexes were detected 1 day before surgery, 2 days after surgery and 7 days after surgery, respectively. SPSS 19.0 software package was used to analyze the data.RESULTS:Energy metabolism indexes in the experimental group were higher than the control group on day 2 after PA surgery and day 7 after ALB and PA surgery, while energy metabolism indexes in the experimental group were lower than the control group on day 2 and day 7 after FPG and TG surgery with significant difference(P<0.05). The levels of IgA, IgG, IgM, CD3+, CD4+ and CD4+/CD8+ in the experimental group were higher than those in the control group 7 days after surgery, with significant differences (P<0.05). The levels of CRP, TNF- and IL-6 in the experimental group were lower than those in the control group 7 days after surgery, and the difference was significant(P<0.05). There was no significant difference in postoperative complications between the two groups.CONCLUSIONS:Dynamic nutrition support can improve postoperative energy metabolism of patients with oral and maxillofacial tumors, improve immune function, and alleviate stress response.

目的:比较4种冲洗剂及冲洗剂组合冲洗桩道后对纤维桩修复中粘接树脂与桩道牙本质壁粘接强度的影响,为临床应用提供参考依据.方法:搜集60颗单根管离体牙常规根管治疗及桩道预备后随机分为4组,分别采用4种冲洗剂及冲洗剂组合对桩道进行冲洗.A组:3％过氧化氢溶液,B组:5.25％次氯酸钠溶液、17％EDTA溶液交替冲洗,C组:0.2％氯己定溶液,D组:17％ EDTA溶液.从四组中分别随机选取10颗牙齿进行纤维桩粘接,通过推出实验测试各组的粘接强度.在扫描电镜下观察各组余留5颗牙桩道表面牙本质微观形态.结果:A、B、C、D组粘接强度分别为11.93±2.59(MPa)、15.87±1.79(MPa)、15.03±2.85(MPa)、19.24±2.87(MPa)(AvsB,P＜0.01;AvsC,P＜0.01;AvsD,P＜0.01,BvsC,P＞0.05,BvsD,P＜0.01,CvsD,P＜0.01).扫描电镜观察A组牙本质小管绝大多数被堵塞,牙本质表面大量碎屑;B组牙本质小管均开放,管周呈白垩色;C组多数牙本质小管被部分堵塞,牙本质表面无碎屑;D组牙本质小管均开放,表面呈云雾状.结论:17％ EDTA溶液是一种有效的桩道冲洗剂,在纤维桩修复临床工作中应用可获得良好的粘接效果.

目的:观察高蛋白肠内营养液对口腔颌面部恶性肿瘤患者术后营养状况的影响.方法:选取颌面部恶性肿瘤择期手术患者46例,随机分为实验组(23例),对照组(23例).实验组给予高蛋白肠内营养液进行营养支持,对照组给予均衡肠内营养液,分别于术前1天、术后7天检测人体测量指标、营养指标、记录术后肠内营养液耐受情况及并发症的发生率.结果:实验组体重、TSF、ACM、体重丢失率下降小于对照组(P＜0.05);术后第7天实验组血清中的总白蛋白(TP)、白蛋白(ALB)、血红蛋白(Hb)与对照组比较无明显差异;实验组前清白蛋白(PA)、淋巴细胞总数(LY)、转铁蛋白(TF)显著高于对照组(P＜0.05);两组均能耐受肠内营养液,并发症无差异.结论:颌面部恶性肿瘤术后病人可耐受高蛋白肠内营养液,早期应用有效减轻体重下降,改善其营养状况.

Objective To investigate the pathogenesis,pathological type and other clinical features of salivary gland tumors (SGTs).Methods Clinical data of patients with SGT underwent surgery in our hospital from January 1995 to Decem ber 2014-were collected.Their gender,age,pathological types,and benign and malignant composition ratio,etc.were analyzed.Results In the past 20 years,a total of 2187 patients with SGTs were treated.Ratio of male to female was 1 ∶ 1.01 (1089/1098).Age:10 to 93 years old.The median age was 55,and the most commonly seen age group was 50-59 (22.45％).The ratio of benign and malignant was 2.42 ∶ 1 (1548/639).The top three tumors-pleomorphic adenoma (45.50％),Warthin tumor (18.93％) and adenoid cystic carcinoma (7.86％)-accounted for 72.29％ of all the patients.In patients of over 65 years old,Warthin tumor and pleomorphic adenoma were the top two,and in the malignancy,acinic cell carcinoma (7.61％) and adenoid cystic carcinoma (7.61％) were the most,the ratio of benign to malignant was 2.31 ∶ 1.Conclusion Surgical cases of salivary gland tumors increase year by year,and the proportion of male and female is equal.Among them,the most common type was pleomorphic adenoma,Warthin tumor and adenoid cystic carcinoma,benign tumors accounted for 70％.Warthin tumor was mostly seen in patients over 65,with a higher proportion of malignant.

Objective To investigate the the treatment of class Ⅲ malocclusion by orthognathic surgery combined with postoperative orthodontics.Methods Nine patients with skeletal class Ⅲ malocclusion were treated by "surgery-first approach" without pre-surgical orthodontic from January 2012 to August 2014.The studied sample consisted of 7 women and 2 men (aged 15-28 years old, mean age 19.7 years), who had obvious mandibular protrusion.2 to 3 days after surgery, intermaxillary traction was used to made the maxilla and mandible together by board;we replaced a rubber band every 2 to 3 days and lasted for four weeks.We would dismantle board and performed conventional orthodontic treatment after patient's facial swelling subsided, and the positional relationship between the jaw stabilized.Results The face type of 9 patients were greatly improved after orthodontic treatment for 6.5 to 19.5 months.Patients and their family members felt satisfied, and their occlusal function returned to normal.At 3 to 32 months follow-up, the postoperative appearance and occlusion were becoming good without obvious signs of recurrence.Conclusions The "surgery-first approach" is an effective method to treat skeletal class Ⅲ malocclusion.

Background: Analyze the stress status of temporal-mandibular joint (TMJ) of a healthy volunteer under the overlarge jaw opening status through the finite element method, with the purpose of clarifying the loading features of each structure in the joint area, and achieving further understanding of the pathogenesis of the temporomandibular disorders (TMD). Methods: Collect the CBCT and MRI data of a volunteer respectively under the maximum jaw opening, establish the finite element model (FEM) of TMJ under the maximum jaw opening status through a series of software, image segmentation, rectification, meshing, material evaluation and other related processing, simulate the mechanical environment of this joint area under this status, and analyze the stress status of the articular disc, condyle cartilage, and condyle process. Results: Based on CT and MRI image data, build 3D model and FEM of TMJ, fully simulate the mechanical environment under the large jaw opening status, and calculate the stress value of the articular disc, condyle process and condylar cartilage. Conclusions: This research result reminds us that the normal people's articular disc are easy to generate stress concentration under large jaw opening, but its stress is far less than the one under the tight biting status. Perhaps the TMJ symptom induced under the large jaw opening status is mainly caused by the displacement of the articular disc. Under the large jaw opening status, the condylar cartilage plays a vital role in dispersing the stress. This method can be applied for carrying out individualized mechanical analysis on the patients with TMD.

The present study reports two cases of mandibular metastasis from hepatocellular carcinoma (HCC), including the clinical presentation, and computed tomography (CT), histopathology and immunohistochemistry results. Space-occupying lesions occurred unilaterally as an initial mandibular manifestation. HCC metastasis was confirmed by post-surgical examination, and the primary tumor was found using CT scans. Hepatitis B virus infection history and positive results of hepatitis B surface antigen, hepatitis B e-antibody, hepatitis B core antibody and hepatitis B virus pre-S1 antigen further supported the pathogenesis of HCC. Based on the clinical findings, the characteristics of the CT scans and the histopathology and immunohistochemistry results, the mechanisms of HCC metastasis and its management are also discussed.

The aim of the present study was to investigate the generation of cell sheet-engineered bones used for the reconstruction of mandibular defects. Bone marrow stem cells (BMSCs) were cultured and induced to generate osteoblasts. Poly(lactic-co-glycolic acid) (PLGA) scaffolds were wrapped with or without cell sheets and then implanted into dogs with mandibular defects in the right side (experimental group) or the left side (control group), respectively. Subsequently, X-ray analyses, and hematoxylin and eosin staining were performed at various time points (at 4, 8, 12 or 16 weeks post-implantation; n=4 at each time point). The osteogenesis in the experimental group was significantly improved compared with that in the control group. At 16 weeks after implantation, numerous Haversian systems and a few lamellar bones were observed at the periphery. In the control group, the engineered bone (without BMSC sheets) presented fewer Haversian systems and no lamellar bones. The optical density of the fresh bone in the experimental group was significantly higher compared with that in the control group (P<0.05). In conclusion, tissue-engineered bone with the structure of lamellar bones can be generated using BMSC sheets and implantation of these bones had an improved effects compared with the control group. Cell sheet transplantation was found to enhance bone formation at the reconstruction site of the mandibular defects.

目的 观察富血小板血浆(PRP)对大鼠颅骨缺损成骨的影响,并探讨其作用机制.方法 常规制得牛煅烧骨,将第3代骨髓间充质干细胞(BMSCs)悬液加到煅烧骨上,制成BMSCs复合体.在Wistar大鼠颅骨正中缘备出长宽比例为1.0 cm×0.8 cm大小缺损,将大鼠随机分为4组,模型组只植入煅烧骨,BMSCs组植入煅烧骨+BMSCs(简称复合体),血管内皮生长因子(VEGF)组植入复合体+VEGF,PRP组植入复合体+PRP.检测1周肿瘤坏死因子-α(TNF-α)和白细胞介素-6 (IL-6)含量,取4、8、12周颅骨行组织形态学检查,观察血管和新骨形成情况并分析其相关性.结果 血清TNF-α和IL-6的含量模型组最高,PRP组最低(P＜0.01);4、8、12周移植骨新骨所占面积的百分比分别为:PRP组(33.28±4.70,60.31±7.18,79.69±6.66)、VEGF组(28.56±6.21,43.46±5.98,65.53±5.27)、BMSCs组(20.84±3.49,36.77±6.56,52.01±5.86)、模型组(14.83±2.83,25.71±5.79,36.41±6.36),F检验差异有统计学意义(P＜0.01),PRP能促进移植骨的形成.结论 PRP可促进移植骨新骨形成和颅骨缺损修复,并发现PRP的作用强于VEGF.

The aim of the present study was to construct functional tissue-engineered bone with cell sheet technology and compare the efficacy of this method with that of traditional bone tissue engineering techniques. Canine bone mesenchymal stem cells (BMSCs) were isolated using density gradient centrifugation and then cultured. The BMSCs were induced to differentiate into osteoblasts and cultured in temperature-responsive culture dishes. The BMSCs detached automatically from the temperature-responsive culture dishes when the temperature was reduced to 20°C, forming an intact cell sheet. Demineralized bone matrix (DBM) and platelet-rich plasma (PRP) were prepared and used to construct a DBM/PRP/BMSC cell sheet/BMSC complex, which was implanted under the left latissimus dorsi muscle in a dog model. A DBM/PRP/BMSC complex was used as a control and implanted under the right latissimus dorsi muscle in the dog model. Immunoblot assays were performed to detect the levels of growth factors. Osteogenesis was observed to be induced significantly more effectively in the DBM/PRP/BMSC cell sheet/BMSC implants than in the DBM/PRP/BMSC implants. Immunoblot assay results indicated that the levels of the growth factors platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) in the experimental group were 3.2- and 2.5-fold higher compared with those in the control group, respectively. These results indicated that the BMSC cell sheets were functional and more effective than the control cell complex. Therefore, cell sheet technology may be used for the effective construction of functional tissue-engineered bone with ideal properties.

Objective To construct bone marrow stem cell sheets and to investigate its effects in the process of osteogenesis.Methods BMSCs were differentiated into osteoblasts and then seeded into a temperature responsive culture dish to construct BMSC sheets.PLGA scaffolds in which both BMSC suspension and BMSC sheets were added,were implanted into the left side of the dogs' mandible.In the other side,PLGA scaffolds that were not wapped with BMSC sheets were implanted as control.At 16 weeks,the samples were processed for radiological analysis and histological examination.Results Cells in the BMSC sheets grew well.In the experimental side,the optical density of the samples was higher than that of the control side (P＜0.05) and plenty of lamellar bones and Haversian system were observed.Conclusions The formation of lamellar bones can be promoted by PLGA scaffolds and BMSC sheets in the process of tissue engineering bone reconstrution.

Purpose: The aim of this study was to construct functional tissue-engineered bone in dogs using cell sheet engineering, a new technique to gain and transfer seed cells.Materials and Methods: Demineralized bone matrixes, prepared from homologous bone, were coated with recombinant human bone morphogenetic protein-2. Bone marrow stromal cells (BMSCs) were isolated and subcultured. Osteogenic-induced BMSCs were incubated in a temperature-responsive culture dish to form the BMSC sheet. The complex of demineralized bone matrix, recombinant human bone morphogenetic protein-2, and BMSCs wrapped with BMSC sheets was implanted around the blood vessels of the latissimus dorsi muscle in the experimental side, and the same complex without BMSC sheets was implanted around the blood vessels of the latissimus dorsi muscle on the other side as a control. At 4, 8, 12, and 16 weeks after implantation, the implants were removed for radiographic evaluation, descriptive histologic observation, and histologic quantitative analysis.Results: Radiographic analysis showed that the optical density of the tissue-engineered bone on the 2 sides increased with time. However, the optical density of the experimental side was significantly greater than that of the control side at the same points. Sixteen weeks after implantation, mature lamellar bone was formed in the experimental side, with red bone marrow in the bone marrow cavity. In contrast, the control side exhibited significantly less lamellar bone. Histologic quantitative analysis showed that the experimental side exhibited significantly more bone per area compared with the control side.Conclusion: BMSC sheet engineering may be useful to construct functional tissue-engineered bone. (C) 2013 American Association of Oral and Maxillofacial Surgeons

Objective: Comparing the Accuracy of computed tomography (CT) and 99mTc-methylene-diphosphonate (MDP) SPECT/CT fusion imaging in determining the extent of mandibular invasion by squamous cell carcinoma of the oral cavity, to study the clinical value of SPECT/CT fusion imaging in evaluating the extent of mandibular invasion by squamous cell carcinoma of oral cavity. Material and Methods: Fifty-one patients were revealed mandibular invasion by moderately differentiated squamous cell carcinoma of the oral cavity underwent CT and SPECT/CT. The patients were divided into two groups: A group (oral mucosal squamous cell carcinoma) and B group (primary intra-osseous carcinoma). Two radiologists assessed the CT images and two nuclear medicine physicians separately assessed the SPECT/CT images in consensus and without knowledge of the results of other imaging tests. The extent of bone involvement suggested with an imaging modality was compared with pathological findings in the surgical specimen. Results: The pathological findings as the reference standard ,group A:the extent of mandibular invasion by moderately differentiated squamous cell carcinoma underwent SPECT/CT was 1.02±0.20cm lager than the pathological examination identified, and the extent of mandibular invasion underwent CT was Advances in Cancer: Research & Treatment 2 1.42±0.35cm smaller than the pathological examination identified. There were statistically significant differences among the three methods, p<0.01. Group B: the extent of mandibular invasion by moderately differentiated squamous cell carcinoma underwent SPECT/CT was 1.3±0.39cm larger than that underwent pathological examination. The extent of mandibular invasion underwent CT was 2.55±1.44cm smaller than the pathological examination identified. There were statistically significant difference among the three methods (p<0.01), too. Conclusion: SPECT/CT fusion imaging in identifying the extent of squamous cell carcinoma of the oral cavity on mandibular invasion has important clinical value. The extent of mandibular invasion underwent SPECT/CT was the extent which surgeon to reach the clear margins to the limits of resection.

AIM:The purpose of this study was to determine whether susceptibility to oral tongue squamous cell carcinoma (OSCC) is related to polymorphisms in the u-PA gene.METHODS:We examined the rs2227564 C/T and rs2227562 G/A single nucleotide polymorphisms (SNPs) in 196 OSCC patients and 201 age- and gender- matched controls via direct sequencing and PCR-RFLP methods.RESULTS:Significant differences were found in allelic and genotypic distributions of the rs2227564 and rs2227562 loci when comparing cases and controls. In addition, logistic analyses indicated that the rs2227564 C/T genotype was related to a 1.52-fold increased risk of developing OSCC (adjusted OR=1.521, 95%CI: 1.144~2.022, P=0.004). Linkage disequilibrium analysis was conducted and no association between the two loci was found (D'=0.031, r2=0.000).CONCLUSIONS:Our findings provide evidence that the rs2227564 C/T SNP in the u-PA gene is associated with the development of OSCC.

The aim of our study was to compare the value of computed tomography (CT) and 99mTc-methylenediphosphonate (MDP) SPECT (single photon emission computed tomography)/CT fusion imaging in determining the extent of mandibular invasion by malignant tumor of the oral cavity.

<正>复发性坏死性黏液腺周围炎是复发性口疮的最重型,溃疡疼痛剧烈,病程常迁延数月或更久,病变有由口腔前份向后发展的倾向,给患者带来很大痛苦,最终诊断常需根据溃疡好发部位、溃疡