Objective: To study the incidence and related risk factors for new-onset temporomandibular joint disorder after mandibular surgery to provide clinical guidance. Materials and methods: The medical records of patients who underwent open reduction and internal fixation formandibular fractures between September 2020 andJune 2023 were retrospectively analysed, and their personal information and the incidence and pathogenic factors of temporomandibular joint disorder before surgery were recorded. Patients were followed up at 3 months, 6 months, and 1 year after surgery to investigate the incidence and pathogenic factors of postoperative temporomandibular joint disorder. Results: A total of 121 patients were included in this study, 33 of whomdeveloped temporomandibular joint disorder, accounting for 27.27% of the study population, and 88 patients who did not develop temporomandibular joint disorder, accounting for 72.73% of the study population. Univariate analysis revealed significant differences in abnormal occlusion and healing rates, unilateral chewing rates, and deep overbite of the anterior teeth rates (P <0.05). There was no significantdifference in age, sex, fracture area, cause of trauma, infection rate, bruxism rate, empty chewing rate, or postoperative anxiety rate between the two groups (P >0.05). Binary logisticregression analysis revealed that abnormal occlusion and healing (OR=0.044) and unilateral chewing (OR=0.142) may be risk factors for new-onset temporomandibular joint disorder after maxillofacial fracture surgery. Conclusion: During the follow-up period, long-term postoperative occlusal habits should be established, and attention should be given the patients’ postoperative psychological state. Accurate digital reconstruction of the occlusal relationship is needed fortreating mandibular fractures.

Background Third molar (M3) extraction is a common surgery in oral and maxillofacial surgery, and composite wound dressings such as hydroxybutyl chitosan (HBC) may improve postoperative sequala following M3 removal. Purpose The study purpose was to measure and compare differences in pain, swelling, trismus, wound healing, and quality of life (QOL) between the HBC and the control sides in patients undergoing M3 removal. Study Design, Setting, Sample This study is a double-blind, split-mouth, randomized clinical trial. Patients who required M3 removal between June 2022 and May 2023 were included. Exclusion criteria included seafood allergies, smoking, poor oral hygiene, and systemic diseases. Predictor Variable The predictor variable was the socket treatment technique. Subjects were randomly assigned to the HBC or control (physiological saline) side. Main Outcome Variable The primary outcome variables, including pain assessed by visual analog scale, swelling, and maximal incisional opening, were measured on the first, third, and seventh postoperative days. The secondary outcome variables included QOL and wound healing score measured on the third and seventh days after surgery. Covariates The covariates included age, sex, and operation time. Analyses The Shapiro‒Wilk test was used to evaluate the normality of the data distribution. The paired t test or Wilcoxon signed-rank test was adopted. Statistical significance was set at P < .05. Results The study included 60 patients (mean age: 25.81 ± 4.91; 23 (38%) males, 37 (62%) females). A statistically significant difference in the level of pain (HBC: 37.58 ± 4.39 mm, control: 47.00 ± 4.33 mm, day 1, P < .001; 21.88 ± 3.25 mm, 35.95 ± 1.57 mm, day 3, P < .001), maximal incisional opening (23.92 ± 1.38 mm, 18.22 ± 1.82 mm, day 1, P < .001; 30.00 ± 1.61 mm, 23.78 ± 1.70 mm, day 3, P < .001), and swelling (6.86 ± 0.70 mm, 7.15 ± 0.80 mm, day 3, P = .006) was detected after surgery. A statistically significant difference in QOL was detected (HBC: 13.70 ± 1.65, control: 18.60 ± 2.14, day 3, P < .001). Conclusion and Relevance The application of HBC hydrogels to wounds after impacted mandibular M3 extraction reduces postoperative sequalae, promotes wound healing and improves postoperative QOL.

ObjectiveThe margin status of oral squamous cell carcinoma patients is considered to be predictive of recurrence and long-term survival. Therefore, precise intraoperative margin assessment is crucial. This study investigated the feasibility of using near-infrared fluorescence imaging technology to guide margin design in oral squamous cell carcinoma patients.MethodsIn this retrospective study, indocyanine green solution was intravenously injected preoperatively into patients. Intraoperatively, the surgical area was illuminated using a near-infrared fluorescence imaging system, which caused the lesion to fluoresce in the surgical area. Surgery was performed with the assistance of fluorescence imaging. The fluorescence intensity of the lesion area and surrounding normal tissue was recorded during surgery. Intraoperative margins were sent for rapid pathology, and postoperative margin pathology results were documented.ResultsSixteen patients were included in this study (7 males, 9 females), with an average age of 65.65 ± 12.37 years. Preoperative biopsy and postoperative pathology confirmed oral squamous cell carcinoma in all patients. No cancer cells were found in the margin pathology results. The average fluorescence intensity of the lesion area was 214 ± 4.70, and that of the surrounding normal tissue was 104.63 ± 3.14. There was no significant difference in the fluorescence intensity values of the lesion areas among all patients (F=0.38, P>0.05). There was a significant difference in fluorescence intensity between the lesion area and surrounding normal tissue (t=33.76, P<0.05).ConclusionNear-infrared fluorescence imaging technology can aid in real-time imaging differentiation of lesion areas based on differences in fluorescence intensity during surgery. The use of this technology can assist surgeons in assessing the safety margin and reliably guide surgery.

Abstract Objective Restoration of the occlusal relationship is critical in the treatment of maxillofacial fractures. Poor restoration of the occlusal relationship has a serious impact on the patient's oral function and physical and mental health. Materials and Methods This study is based on computer-aided design and manufacturing and aimed to use computed tomography (CT) data to establish a maxillofacial bone model and perform virtual reduction of such fractures. The upper and lower dentition models were established and reconstructed via 3D printing. After the occlusal relationship was determined by the prosthodontist using the model, the occlusal relationship was obtained through an oral three-dimensional scanner. Based on the reconstructed occlusal relationship, an occlusal reduction guide plate was designed and manufactured to precisely reduce the occlusal relationship in patients with maxillofacial fractures. Results This study proposes a design process for occlusal guides for maxillofacial fractures that optimizes the traditional surgical processes and enhances surgical convenience. Conclusion This study presents new ideas for the design of personalized surgical guides for maxillofacial fractures. Clinical Relevance: The application of the occlusal guide can assist the surgeon to accurately reset the occlusal relationship and fix the occlusal relationship, which can significantly improve the operation efficiency.

目的 应用生物信息学和分子生物学实验探讨Dick-kopf相关蛋白1(DKK1)在舌鳞状细胞癌(TSCC)中的表达及分子机制.方法 从TCGA-TSCC数据库下载患者信息,利用NetworkAnalysed网站筛选正常组织和癌组织间的差异表达基因,通过Kaplan-Meier分析和Lasson回归法寻找关键基因及临床预后,应用GO和KEGG分析差异表达基因的功能和通路,应用UALCAN数据库和免疫组化实验分析DKK1蛋白在TSCC中的表达,并分析其与临床病理特征的关系,应用Western blot实验检测DKK1 在TSCC细胞中的表达,利用siRNA敲低Cal27 细胞中DKK1 蛋白的表达.结果 Net-workAnalysed、Kaplan-Meier分析和Lasson回归法筛选出的 3个关键基因DKK1、CYP19A1 和IRX4 在TSCC中高表达,且高表达组的患者生存率差.UALCAN 数据库分析显示DKK1 的mRNA水平在TSCC组织中高于正常组织,其高表达与TSCC患者的临床分期、组织学分级和淋巴结转移相关.免疫组化实验显示,DKK1 蛋白在临床分期Ⅲ+Ⅳ期TSCC组织中的阳性率高于Ⅰ+Ⅱ期TSCC组织.与癌旁组织相比,DKK1 蛋白在TSCC组织中的表达水平升高.West-ern blot实验显示DKK1 蛋白在TSCC细胞Cal27 中的表达高于正常口腔上皮细胞 HOEC.在 TSCC 细胞 Cal27 中敲低DKK1 的表达后,β-catenin、p-p65 和 p65 蛋白表达量减少.结论 DKK1 在 TSCC组织和细胞中高表达且发挥重要作用,其可能作为TSCC早期诊断和药物治疗的新靶点.

Objectives: In the field of computer-assisted surgery, 3D printing technology and computer-aided navigation (CAN) technology have led to advances in craniofacial surgery. However, the application of these two techniques in maxillofacial fractures is mostly limited to unilateral zygomatic bone and zygomatic arch fractures, and few studies have investigated their use for multiple maxillofacial fractures. This study summarizes the combined application of 3D printing technology and CAN for complex maxillofacial fractures to guide clinical practice. Materials and methods: Twenty-six patients with multiple maxillofacial fractures from 09/2017 to 03/2021 were retrospectively studied and divided according to surgical method into an experimental group (navigation-aided surgery combined with a 3D-printed guide) and a control group (navigation-aided surgery only). The surgical time was compared between the groups, and posttreatment computed tomography and follow-up visits were conducted at 1 week and 3 months, respectively, to compare the quality of treatment in terms of infection, occlusal disorder, restricted mouth opening, midline displacement, and bilateral asymmetry. Results: According to our results, the combined use of CAN and 3D printing significantly improved the treatment results of double-sided maxillofacial fractures (rs = 0.448, P < 0.05). The surgical time of the experimental group was significantly shorter than that of the control group (Z = -2.083, P < 0.05). Conclusions: This study broadens our understanding of the treatment of multiple maxillofacial fractures. The combined use of 3D printing technology and CAN effectively shortened the operation time and achieved a better therapeutic effect. (c) 2023 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Background: Ambulatory surgery and single-visit surgery are becoming increasingly accepted and practiced. Materials and methods: The clinical data of patients undergoing ambulatory surgery were collected, and infor-mation on their chief complaint and basic information was specifically included. Follow-up phone calls were conducted 1 and 3 days, 1 and 2 weeks, and 1 month after treatment. Information on their recovery and well-being was collected. Results: A total of 427 patients (males: 224, females: 203, average age: 23.07 +/- 11 years) were recruited for this study. A total of 43.55% of the patients chose ambulatory surgery. A total of 62.9% of them selected it for convenience, while 43.55% selected it for pain reduction. The top three diseases treated by ambulatory sur-gery were impacted teeth (56.7%), jaw cyst (14.75%) and supernumerary teeth (10.07%). Postoperative com-plications occurred in 248 of the 427 patients, with an incidence rate of 58.08%. The complication that occurred most frequently was postoperative pain (56.44%). Complications frequently occurred on Day 3 after the operation and resolved after 2 weeks. Conclusion: After being diagnosed, ambulatory surgery is an effective mode of treatment for oral and maxillo-facial diseases. Oral hygiene, professional postoperative follow-up visits and rigorous anesthesia evaluation are very important for ambulatory surgery for oral and maxillofacial diseases.(c) 2022 Elsevier Masson SAS. All rights reserved.

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 研究和讨论种植体相关危险因素在早、晚期失败中的影响差异,以指导种植的术前准备与术后维护,提高种植体留存率.方法 收集2011年1月至2018年12月期间,在合肥市口腔医院行种植修复的7334名患者中种植体失败的177例病例,按失败时间分为早期失败组和晚期失败组,分别统计可能影响患者种植体失败的相关危险因素,分析两组数据间的差异.结果 种植体早期失败与晚期失败在性别、植入部位、种植体尺寸及是否使用骨替代材料等因素上的差异有统计学意义.女性患者、前牙区、植入骨替代材料更易发生早期失败,男性患者、后牙区更易发生晚期失败.结论 完善的术前评估与危险因素的预防性治疗可有效降低种植体的早期失败率.术后定期随访、控制风险因素、及时的种植体维护性治疗可有效的预防种植体的晚期失败.