Objective:To explore the computer-aided navigation technology combined with personalized three-dimensional(3D) printing in the reduction and fixation of the multiple midface fractures.Methods:A retrospective analysis was performed on clinical data of patients suffering from multiple midface fractures treated at the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Anhui Medical University from August 2019 to December 2021. According to the operational method, the patients in the experimental group received the operation applied by AccuNavi-A 2.1 navigation software for surgical planning and surgical simulation, printing 3D head model before the operation, and reducing and fixing fractures with the aid of computer navigation technology. Patients in the control group received the operation applied by traditional surgery. Marking facial landmarks on the head CT 3D model of patients and constructing a spatial coordinate system before and 1 week after surgery, measuring and calculating the facial asymmetry index (AI) for each landmark, including the orbitale (O), the most outside of the zygomaticomaxillary suture of the 1/3 below of the margo infraorbitalis(MZ), the most concave point between the frontal process of zygomatic bone and the superior margin of processus temporalis(C), the most concave point of the superjacent of C of posterior margin of frontal process(SC) and the outermost point of zygomatic arch(Z). The duration of operation were recorded. Complications including diplopia, difficulty in mouth opening, facial numbness, malocclusion, scarring and pupil height were evaluated by patents 3 months after the operations. AI is represented by M( Q1, Q3), Wilcoxon rank test was used for intra-group comparison before and after operations, and Mann-Whitney U test was used for comparison between two groups. Operation time was represented by Mean±SD, and t-test was used for comparison between two groups. The result of self-assessment of patients’ complications are expressed as cases (%), and the chi-square test or Fisher’s exact test was used. Results:A total of 32 patients were included. There were 16 patients in the experimental group, 9 males and 7 females, aged 17-60 years. There were 16 patients in the control group, 8 males and 8 females, aged 18-65 years. The preoperative O, MZ, C, SC, and Z point in the experimental group were 8.9(6.9, 12.8), 10.0(7.7, 12.6), 7.6(5.9, 14.9), 10.7(7.2, 22.0), 11.2(10.1, 17.4), and 2.2(1.6, 3.4), 2.5(1.7, 3.4), 2.2(1.9, 2.9), 2.6(1.7, 3.1), 2.4(1.4, 2.8). The preoperative O, MZ, C, SC, and Z point in control group were 10.4(8.1, 12.5), 10.5(9.0, 12.6), 6.6(5.3, 8.2), 10.6(8.7, 13.1), 10.9(9.8, 13.4), and the postoperative were 4.0(3.6, 4.8), 4.3(3.8, 5.4), 5.2(4.8, 6.7), 4.3(3.1, 5.1), 4.6(3.2, 5.3). There was no significant difference in AI of each marker point between the two groups before surgery ( P>0.05). The AI of each landmark in the two groups was reduced after operation compared with that before operation to some extent ( P<0.01 or 0.05). The AI of each landmark in the experimental group was significantly lower than that in the control group( P<0.01). The operation time of the experimental group[(3.7±1.1) h] was shorter than that of the control group[(4.8±1.9) h] ( P<0.05). The incidence of scar[12.5% (2/16)] and inconsistent pupil height[6.3% (1/16)] in the experimental group was lower than that in the control group [43.8% (7/16), 37.5% (6/16)] ( P<0.05). And there was no significant difference in other items ( P>0.05). Conclusions:The computer-aided navigation technology combined with personalized 3D printing can shorten the time of operation, expedite the patients’ facial recovery with more symmetry and less likely to have complications.

目的 分析脑表达的X连锁基因1(BEX1)及脑表达的X连锁基因4(BEX4)在口腔鳞状细胞癌(oSCC)组织中及癌旁非肿瘤组织中的表达并探讨其与口腔鳞状细胞癌发生发展的关系.方法 使用免疫组化法检测BEX1和BEX4蛋白在OSCC组织及癌旁非肿瘤组织中的表达.TCGA数据库中Kaplan-Meier生存分析BEX1和BEX4的表达与口腔鳞癌患者总生存期的相关性.从String-DB数据库中分析BEX1和BEX4在信号转导中的位置以及相关密切的上下游基因.结果 55例OSCC组织中,BEX1蛋白阳性25例(45.45％),BEX4蛋白阳性19例(34.55％);30例癌旁非肿瘤组织中,BEX1阳性24例(80.00％),BEX4阳性27例(90.00％),OSCC组织与癌旁非肿瘤组织相比差异均有统计学意义(P＜0.01),BEX1和BEX4蛋白的表达与口腔鳞癌分期、淋巴结的转移与分化程度存在一定的关联,同时其中存在的差异有统计学的意义(P ＜0.001);然而BEX1与BEX4蛋白的表达与患者的年龄、肿瘤发生部位与性别不存在相关性,差异无统计学意义.关联性分析表明BEX1蛋白和BEX4蛋白表达关联强度为0.489(P＜0.001).Kaplan-Meier生存分析显示BEX1低表达的OSCC患者预后较差.结论 BEX1和BEX4可能成为预测OSCC转移的潜在生物学标志物.

目的 探讨下颌骨良性病变患者术后遗留的颌骨缺损两种不同的充填物形式:富血小板纤维蛋白联合人造骨粉复合物、单纯人造骨粉自体血混合物在颌骨缺损成骨愈合过程中的效果评价.方法 选取下颌骨术后缺损患者约40例,随机分为A、B两组,A组(约20例)采用患者自体静脉血提取物(富血小板纤维蛋白)与人造骨粉复合体充填术后骨腔;B组(约20例)采用单纯人造骨粉与患者颌骨骨腔渗出血液混合物充填.所有病人术后均随访一年以上,比较两组患者在围术期中术后反应、术后长期成骨愈合情况.结果 A组患者围术期术后反应如;肿胀、疼痛程度低于B组患者,且术后成骨效率明显优于B组(P<0.05).结论 富血小板纤维蛋白联合人造骨粉复合物充填下颌骨术后缺损疗效良好,效果可靠.

目的 探讨髁突囊内骨折开放手术治疗的临床疗效.方法 选择2015年1月至2018年7月安徽医科大学第一附属医院收治的27例35侧髁突囊内骨折的患者,所有患者均行开放手术,术后3个月行临床疗效及影像学评估.结果 35侧髁突囊内骨折中,26侧行骨折内固定治疗,9侧行骨折碎块摘除术.3个月后,患者临床治愈率达81.48％,髁突骨折侧的影像学治愈率达88.57％.结论 髁突囊内骨折的开放手术有较好的临床疗效和应用价值.

目的 探讨前臂游离皮瓣在口腔鳞状细胞癌切除术后缺损修复中的临床应用价值.方法 分析2016年6月～2017年06月安徽医科大学第一、第二附属医院收治11例口腔鳞状细胞癌病例的临床资料,术中采用游离桡侧前臂皮瓣Ⅰ期修复重建口腔较大软组织缺损,总结临床手术经验.结果 11例舌、颊、口底等处缺损成功修复,术后外形恢复满意.术后半年随访,大部分患者皮瓣黏膜化明显,全部患者咀嚼功能基本恢复;部分患者舌及口底鳞癌术后语言功能稍有改变.结论 游离桡侧前臂皮瓣移植修复是一种修复口腔颌面部软组织较大缺损的理想皮瓣选择.

目的 评价耳屏前直线型切口穿腮腺入路治疗下颌骨髁突(中、高位)髁突骨折的临床治疗效果.方法 对27例(共29侧)下颌骨中高位髁突骨折患者行骨折切开复位内固定手术治疗,其中14例(15侧)采用耳屏前直线型切口穿腮腺入路;13例(14侧)采用传统切口即拐杖型切口入路;记录两组患者的手术平均时间、开口度、咬合关系、有无面神经损伤、有无涎瘘、有无颞下颌关节症状,通过影像学检查(口腔曲面断层片和颌面部CT三维重建)了解骨折端段的复位情况,评价耳屏前直线型切口穿腮腺入路在下颌骨髁突中、高位骨折复位术中的临床效果.结果 采采用耳屏前直线型切口入路的患者,骨折断端复位良好,手术时间少,开口度、咬合关系明显改善,无涎瘘和面瘫发生.采用拐杖型切口入路的患者,骨折断端复位良好,开口度、咬合关系改善良好,3例有面神经不同程度损伤,无涎瘘发生,1例术后3个月出现颞下颌关节症状及张口末闭口初弹响.结论 耳屏前直线型切口穿腮腺入路治疗下颌骨髁突中高位骨折,骨折断端复位良好,手术时间短、创伤小、并发症少,安全有效,值得临床推广应用.

Myristoylated alanine-rich C kinase substrate (MARCKS) is a protein kinase C substrate functioning in different physiological and pathological mechanisms. Previous studies have suggested that MARCKS is capable of influencing tumorigenesis and progression. However, a limited number of studies are available regarding the role of MARCKS in oral squamous cell carcinoma (OSCC). The present study primarily examined MARCKS expression in the OSCC tissues. Furthermore, increased expression of MARCKS was confirmed in the majority of OSCC tissues. Increased MARCKS expression was correlated with more advanced tumor stages, lymphatic metastasis and a poorer overall patient survival. Further molecular mechanistic examinations revealed that downregulated MARCKS expression inhibited the proliferation and migration of OSCC cells in vitro through interruption of MARCKS expression. In addition, the present study demonstrated that MARCKS aggravated OSCC progression via the phosphoinositide 3-kinase/protein kinase B pathway. Accordingly, the present study considered MARCKS to be a promoter of OSCC tumorigenesis and progression, with the potential utility as a biomarker of a poor prognosis.

Objective To investigate the effect of clinical factors on lymph node metastasis in cN0 tongue squamous cell carcinoma. Methods Totally 104 cases of cN0 tongue squamous cell carcinoma patients were chosen to analyze the effect of gender,age,tumor stage,histological differentiation and preoperative examination methods on occult lymph node metastasis rate and postoperative 1-year forward rate of lymph node metastasis.Results As for occult lymph node metastasis rate,there were significant differences in groups of age,histological differentiation and preoperative examination methods.And as for postoperative 1-year forward lymph node metastasis rate there were significant differences in histological differentiation and preoperative examination methods.Conclusions The forward lymph node metastasis rate is growing with age.And the lower the degree of differentiation of cN0 tongue squamous cell carcinoma patients,the higher rate of its occult lymph node metastasis and 1-year forward lymph node metastasis.Preoperative MRI can effectively reduce the occult lymph node metastasis rate and 1-year forward metastasis rate of cN0 tongue squamous cell carcinoma patients.

Objective:To evaluate the diagnostic accuracy of the cone beam computed tomography in judging the relationship between the impacted teeth and the anatomic structure.Methods:A retrospective review of 35 patients in which their roots overlapped with inferior alveolar nerve canal identified by Panoramic X-ray were selected in the study.An evaluation comparing CBCT and Panoramic X-ray were performed.Results:The CBCT examination gave a good resistance analysis of the impacted teeth.Conclusion:The CBCT examination was very helpful in the surgery of the impacted teeth.

Objective To observe and compare the clinical effect of PBFPF and ADM on repairing the defect of buccal mucosa. Methods Forty-six patients were randomly divided into two groups( PBFPF and ADM) . The post-operative 1 to 6 months MMO, repaired time and patients’ satisfaction of two groups were observed, recorded and analyzed. Results The MMO was statistically less in the group ADM 1~3 days after surgery (P<0. 05). 1~6 months after surgery, statistically significant difference was not found in MMO between the two groups. The re-paired time between the two groups was statistically different ( P<0. 05 ) . And there was no statistically significant difference in the two groups about satisfaction degree. Conclusion The ADM is more flexible of the two methods that successfully satisfy the need to treat buccal benign tumoers and malignant tumors( T2 N0 M0 ) for the first time. Considering the limited number of samples, further study is required to prove the surgical treatment effect of ADM on repairing the disease( T2 N0 M0 or T1 N0 M0 ) taking primary surgical resection.

BACKGROUND:Tumor suppressor gene p53 plays an important role in the maintenance of the genomic integrity, and mutation in the gene may alter an individual's susceptibility to various carcinomas. P53 Arg72Pro or codon 72 polymorphism has been indicated to increase the risk of developing certain cancers such as bladder cancer and cervical cancer. Human papillomavirus (HPV) infection has been shown as a risk factor for certain cancers such as cervical cancer and oral cancer as well, and the HPV oncoprotein E6 may induce the degradation of p53 function. However, the association between p53 Arg72Pro polymorphism and the risk of oral cancer with HPV infection remains inconclusive. Therefore, this meta-analysis involving 5,614 participants was performed to investigate the relations among the p53 Arg72Pro polymorphism, HPV infection, and the risk of developing oral cancer.RESULTS:A search of the literature by PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases was conducted to identify studies based on the inclusion and exclusion criteria. Odds ratios with 95% confidence intervals were combined using a random-effect model or a fixed-effect model. The current study was conducted with 13 studies consisting of 2,413 cases and 3,201 controls. Neither overall analysis nor stratified analyses detected any obvious evidence of association between p53 Arg72Pro polymorphism and oral cancer susceptibility in all genetic models. However, a significant association between p53 Arg72Pro polymorphism and the risk of oral cancer with HPV infection was detected in the Arg/Arg vs. Arg/Pro + Pro/Pro model.CONCLUSION:In the current meta-analysis which used the quantitative data synthesis for the first time, our study demonstrated that p53 Arg72Pro polymorphism together with HPV infection might jointly alter an individual's susceptibility to the risk of oral cancer. Our results suggested that p53 Arg72Pro polymorphism may partly contribute to the pathogenesis of oral cancer development.

Objective This study aims to explore and evaluate internal fixation with double titanium plates in mandibular condylar fracture. Methods Twenty-eight patients with mandibular condylar fracture were treated by rigid internal fixation with double titanium plates. The effects of the treatment on occlusion, mouth opening, and titanium plate rupture were evaluated by pantomograms or 3D CT. Results Good retention was observed in all 28 patients with mandibular condylar fracture. Occlusion and mouth opening returned to normal. None of the patients experienced titanium plate rupture or fracture displacement. Two patients suffered from mild facial nerve injury but recovered within 3 months after neurotrophic drug treatment. Two patients suffered from temporo-mandibular joint disease but improved after plate removal. Conclusion Rigid internal fixation with double titanium plates is an ideal treatment for mandibular condylar fracture.

To evaluate the clinical effects of computer-aided model surgery on the treatment of midface fracture. Seventeen patients with midface fracture were received the preoperative examination of three-dimensional CT re-struction and the CT data were changed into three-dimensional entity models under the help of computer-aided sys-tem. The operation plan can be designed and personalized titian plate can be fabricated on the models. Computer-aided model can quickly and accurately display the three-dimensional anatomy structure of midface fracture. Model surgery simplified the operation and elevated the results. The patients were satisfied after operation. Computer-aided model surgery is a valuable and important method to diagnose and treat midface fracture.

The associations between CYP1B1 polymorphisms and head and neck squamous cell carcinoma (HNSCC) risk have been conflicting. We therefore performed a meta-analysis to derive a more precise relationship. Six published case-control studies were collected; odds ratios (ORs) with 95 % confidence interval (CI) were used to assess the association between CYP1B1 Leu432Val, Asn453Ser polymorphisms, and HNSCC risk. The Sensitivity analysis and publication bias also were performed to guarantee the statistical power. Overall, the pooled OR with 95 % CIs indicated that CYP1B1 Leu432Val polymorphism was significantly related with HNSCC risk (for Val vs. Leu: OR = 1.13, 95 % CI = 1.03-1.25, P = 0.014, P (heterogeneity) = 0.141; for Val/Val vs. Leu/Leu: OR = 1.30, 95 % CI = 1.06-1.60, P = 0.013, P (heterogeneity) = 0.253; for Val/Val vs. Leu/Leu + Leu/Val: OR = 1.23, 95 % CI = 1.05-1.46, P = 0.013, P (heterogeneity) = 0.456). The similar results were also been found in succeeding analysis of HWE and stratified analysis of Caucasian population. Furthermore, no significant association between CYP1B1 Asn453Ser polymorphism and HNSCC risk was found in this meta-analysis. In conclusion, our meta-analysis demonstrates that CYP1B1 Leu432Val polymorphism may be a risk factor for developing HNSCC.

Objective To investigate the clinical value of functional parotidectomy in benign tumor of superficial lobe of parotid gland.Methods Fifty-one patients with benign tumors in superficial lobe of parotid gland(≤3.0cm) were treated with functional parotidectomy,preserving the great auricular nerve,conserving the master duct and main normal parotid tissue,reconstructing the parotidmasseter fascia,resecting the tumor in the 0.5~1.0 cm away from the edge of the tumor within the normal glandular tissue.All patients were followed up for 2 months to 2 years to investigate the rate of postoperative complications and recurrence.Results There was slight facial deformity in 51 patients.The function of parotid gland was nearly normal.There was no obvious earlobe numb,no salivary fistula and gustatory sweating syndrome,no permanent facial nerve injury,but there was transient facial nerve palsy in 5 cases.There was no recurrence during the followed-up.Conclusion Functional parotidectomy has a high clinical value with small surgical trauma and less postoperative complications in smaller benign tumor(≤ 3.0 cm) of superficial lobe of parotid gland.

To evaluate the clinical effects of ultrathin titanium membrane and onlay bone graft in dental implant.Twelve patients with maxilla anterior bone defect were received massive onlay graft bone from mandible chin,and the surfaces of graft bone were covered by ultrathin titanium membrane.No obvious complications were observed after bone graft.In one case the titanium was exposed at postoperative 10 d,but no infection by local prune and washing.3 to 6 months later while in the second operation,the healing of onlay graft bone and base bone was good,and the onlay graft bone absorption was about 7.5%,a total of 21 dental implants were placed.The ultrathin titanium membrane can obviously reduce the onlay graft bone absorption and promote its healing.

Objective To explore the expression and clinical significance of cellular adhesive molecular CD44S and CD44V5 in oral squamous cell carcinoma(OSCC).Methods The expression of CD44S and CD44V5 were examined by immunohistochemical SP method in 12 cases of normal oral tissue(NOT) and 59 cases of OSCC.The expression of CD44S mRNA in 20 cases of OSCC and 12 cases of NOT were detected by RT-PCR.Results The positive expression rates of CD44S,CD44V5 and CD44SmRNA in OSCC were significantly higher than those in NOT.There was significant difference between the two groups(P<0.05).The expression of CD44S and CD44V5 were correlated with pathological grade,clinical stage,lymph node metastasis,but it was not associated with sex,age and tumor size.Conclusion The expression of CD44S and CD44V5 are closely related with pathological grade,clinical stage and lymph node metastasis of OSCC.It can be used as marker to predict potential of metastasis and invasion of OSCC.

颌面部由于其部位特殊,手术的结果常会导致面容及生理功能的损坏.如何在保证治疗成功的同时,尽可能地避免损害面容及生理功能,是口腔颌面外科探索与追求的目标.

Objective: To discuss the esthetics effect of a modified operation technique in the treatment of parotid benign tumors.Methods: This study reviewed 52 patients.The modified technique included a modified incision design,facial nerve and great auricular nerve dissection and preservation,manipulation of the fumor instead of parotidectomy and treatment of remnant acinus.Results: All the incisions healed well.The study showed good figuration and normal function of the parotid region after follow-up 6～18 months.Only three patients had temporary facial hemiprosoplegia and recovered to normal in 3 months.All patients were satisfied with their facial contour postoperatively.No tumor recurrence was found.Conclusion: The modified technique improves the quality of operation,and may obtain better esthetic results.