BACKGROUND:Natural head position (NHP), pharyngeal airway and maxillofacial growth pattern are correlated. The author's previous studies proved that following surgical correction of Skeletal Class II malocclusion, the over-extended NHP returned upright, and the pharyngeal airway space (PAS) dimension expanded. OBJECTIVE:The present study compares the post-operative change in NHP and PAS after orthognathic surgery in Skeletal Class II and III malocclusion patients. METHODS:Patients receiving orthognathic procedures to correct Skeletal Class II or III malocclusions were reviewed in this retrospective study. Pre-operative and 6-week post-operative cone-beam computed tomography datasets were collected. Variables representing the craniofacial pattern, the NHP and the PAS were measured three-dimensionally. Post-operative variables were compared with their pre-operative counterparts using either repeat-measure 2-way analysis of variance or Wilcoxon matched-pairs signed rank test. RESULTS:Thirty cases of Skeletal Class II malocclusion and 13 cases of Skeletal Class III malocclusion were collected. Preoperatively, the inter-group differences were significant in craniofacial pattern (68.14 ± 3.552 degree vs. 79.63 ± 2.497 degree, p < .0001) and the NHP (68.77 ± 11.02 degree vs. 82.83 ± 7.738 degree, p = .0002) while not significant in PAS; after surgery, the intergroup differences in craniofacial pattern and the NHP between groups decreased, and the PAS increased in both groups. CONCLUSION:Orthognathic surgery may improve compromised NHP and increase PAS in Skeletal Class II and III malocclusion patients.

Mandibulotomy provides good access for monobloc compartmental resection of squamous cell carcinoma in the proper oral cavity. Various designs of osteotomy have been reported, but few of them have considered the local anatomical conditions, and thus related complications occasionally happen. We devised a paramedian lateral-angled mandibulotomy to reduce the side injuries.

Squamous cell carcinomas (SCCs) are common malignant tumors in the oral and maxillofacial region. However, SCCs secondary to marsupialization of odontogenic radicular cysts are extremely rare. The authors report an unusual case of a 43-year-old male presented with dull pain in the right molar region of the mandible without numbness of lower lips, who had a long history of smoking, alcohol consumption, and betel nut chewing. Computerized tomography revealed a round well-defined unilocular radiolucent at the apex of lower right premolars, 2 nonvital teeth. The clinical diagnosis was the radicular cyst of the right mandible. The patient was initially treated with root canal therapy of the teeth followed by marsupialization with a mandibular vestibular groove incision. While the patient did not follow the instruction of irrigation of the cyst and had no regular follow-up. The reexamination of computerized tomography indicated a round well-defined unilocular radiolucent at the apex of lower right premolars and filled with a soft tissue without clear boundary with buccal muscles at 31 months follow-up. There were no masses or ulcer around the mandibular vestibular groove incision and the patient had no sign of numbness of lower lips. The clinical diagnosis was the radicular cyst of right mandible with infection. A curettage was performed. However, the pathologic diagnosis was well-differentiated SCC. An extended radical surgical resection including segmental resection of the right mandible was performed. The histopathology was well-differentiated SCC without the cyst epithelium and invasion of bone, which can be distinguished from primary intraosseous SCC. The case indicates that marsupialization performed in patients with a history of smoking, alcohol consumption, and betel nut chewing, has a risk of suffering from oral SCC.

Abstract Objectives The natural head position (NHP), pharyngeal airway, and maxillofacial development are correlated. The author’s previous studies proved that following surgical correction of Skeletal Class II malocclusion, the pre-operative over-extended NHP returned upright, and the pharyngeal airway space (PAS) dimension expanded. The present study compares the post-operative change in the NHP and the PAS after orthognathic surgery in Skeletal Class II and III malocclusion patients. Materials and Methods Patients receiving orthognathic procedures to correct Skeletal Class II or III malocclusions were reviewed in this retrospective study. Their pre-operative and 6-week post-operative cone-beam computed tomography datasets were collected. Variables representing the craniofacial pattern, the NHP, and the PAS were measured three-dimensionally. Post-operative variables were compared with their pre-operative counterparts using either repeat-measure 2-way analyses of variance or Wilcoxon matched-pairs signed rank test. Results Forty-three cases of 61 patients were involved. After surgery, the differences in craniofacial pattern and the NHP between Skeletal Class II and III malocclusion groups decreased, and the PAS increased in both groups. Conclusion Orthognathic surgery corrects dysgnathia, neutralizes the NHP, and increases the PAS in Skeletal Class II and III malocclusion patients. Clinical relevance Orthognathic surgery provides potential benefits to NHP and pharyngeal airway in addition to correcting maxillofacial deformities.

PURPOSE To investigate the correlation of clinicopathologic factors and immunophenotypic features with betel nut chewing in oral squamous cell carcinoma(OSCC). METHODS The data of 88 patients with OSCC were collected. According to the habit of betel nut chewing, the clinicopathologic factors and immunohistochemical parameters were analyzed. The relationship between clinicopathologic factors of OSCC and betel nut chewing was analyzed with univariate analysis and multivariate analysis using SPSS 17.0 software package. RESULTS 46.6% of patients had the habit of betel nut chewing and 67.0% of patients had tongue cancer and buccal cancer. The pathological stages were mainly T2 (40.9%). From univariate analysis of the results, differentiation degree, ki-67, p53 was significantly correlated with the habit of betel nut chewing(P<0.05); while gender, age, location, pathological T stage and cervical lymph node metastasis were not significantly correlated with habit of betel nut chewing (P>0.05). From multivariate analysis of the results, location and differentiation degree were significantly correlated with the habit of betel nut chewing (P<0.05). CONCLUSIONS ki-67 and p53 protein are lowly expressed in OSCC patients with the habit of betel nut chewing, suggesting that clinicopathologic factors such as the proliferation activity, malignancy, differentiation and prognosis of tumor are much better. Differentiation degree are relatively good in OSCC patients with the habit of betel nut chewing. Cheek and tongue are the most common site of OSCC.

Intraosseous lipomas are rare benign tumors of the bone, especially for the mandible. The etiology remains unclear, although several hypotheses have been proposed, such as trauma, blood vessel infarction, aging and inflammation. Clinically, the symptoms mainly depend on the location and size of the tumors. Radiographically, the lesions are usually radiolucent occasionally accompanied by radiopacity. The diagnosis is challenging, and histopathologic examination is necessary for definite diagnosis. Herein, the authors report an unusual patient with intraosseous lipoma in the mandibular condyle.

评价达芬奇机器人模拟机在培训口腔住院医师机器人基本操作技能的效果.选取我院口腔科规培医师16名作为纳入本研究,每名医师每天在模拟机上培训2小时,培训7天,分别记录第一小时后和全部培训结束后每名学员的模拟机评分,用配对t检验检测训练效果.16名学员培训后评分提高,差异具有统计学意义(P＜0.05).达芬奇机器人模拟机可以提高口腔科规培医师的机器人操作基本技能.

Pseudovascular adenoid squamous cell carcinoma (PASCC) is an uncommon histologic variant of squamous cell carcinoma, characterized by acantholysis in the cancer nests resulting in a pseudovascular appearance, and a subtype of acantholytic squamous cell carcinoma. It is relatively common in sun-exposed skin, but is extremely rare in oral cavity. A 56-year-old woman was referred to our department presented with a fast-growing mass in the front of the tongue for more than two months. Physical examination revealed a exophytic lesion with a pedicle in the anterior tongue. An incisional biopsy was performed. On microscopic examination, the tumor was composed of vessel-like anastomosing channels and dilated vessel-like spaces, similar to hemangioma, and the anastomosing channels contained free tumor cells. The nests of tumor cells with significant acantholysis were observed in some regions. Immunohistochemical examination revealed cells positive for pan-CK, CK5/6, p63, and negative for CD31 and CD34. The pathological diagnosis was confirmed as pseudovascular adenoid squamous cell carcinoma. The extended resection of the tumor and neck dissection was performed. There was no tumor recurrence or distant metastasis after 15 months of follow-up.

Objective: To explore the feasibility of using da Vinci Surgical System to perform supraomohyoid neck dissection (SOND) to avoid visible scar and reduce trauma. Methods: Between September 2017 and December 2018, twenty patients (two females and 18 males, mean age, 54.8 years) with oral cancer treated in the Department of Stomatology, Hainan Hospital of General Hospital of Chinese PLA were enrolled in this study. Eight patients were assigned into robotic surgery group, and received robot-assisted SOND with retroauricular hairline incision. After the da Vinci Surgical System robotic platform was positioned, the neck dissection was performed in level Ⅱb, Ⅱa, Ⅲ, Ⅰb and Ⅰa orderly from the near region to far region. The other 12 patients were assigned into traditional surgery group, and received SOND with a traditional incision. The operation time, bleeding and amount of lymph node dissected were compared between two groups. Results: All the 8 cases of robot-assisted SOND were completed smoothly. Operation time [(4.5±1.0) h] was significantly longer in robotic surgery group than that [(2.5±1.0) h] in traditional surgery group (P<0.05). The amount of bleeding in robotic surgery group [30.0 (27.5) ml] was significantly lower than that in traditional surgery group [(100.0 (87.5) ml, P<0.05]. There's no difference in the number of lymph nodes dissected between robotic surgery group (23.6±5.2) and traditional surgery group (22.8±6.0)(P>0.05). No postoperative hemorrhage, symptoms of nerve injury, flap necrosis and secondary healing were observed in robotic surgery group. Conclusions: SOND through retroauricular hairline incision is feasible with the assistance of da Vinci Surgical System. The main advantage of this method is superior esthetic effects due to a hidden incision with minimal bleeding. There was no obvious differences in the amount of lymph nodes dissected and postoperative complications between two methods. However, robotic surgery costs a significantly longer operation time than traditional neck dissection.

In surgical removal of a submandibular gland, trans-cervical approach has esthetic problem and existing trans-oral approaches are extensively invasive. The authors have used trans-oral robotic surgery to remove the submandibular gland with preservation of the sublingual gland and the Wharton's duct, and hereby report the case and discuss our preliminary experiences.

The increase in the pharyngeal airway space after mandibular advancement has not been well explained, and in this study we aimed to show whether there is a correlation in the increase of pharyngeal airway space as a consequence of the mandibular advancement or of the relative change between the mandibular position and the natural head position (NHP). Fifteen patients who had bilateral sagittal split osteotomy for mandibular advancement with or without genioplasty were studied retrospectively. The primary variables of mandibular position, NHP, and pharyngeal airway space were measured in three dimensions using preoperative and postoperative cone-beam computed tomographic datasets and were compared using the paired t test. The secondary variable of pharyngeal airway space was defined as the square root of the mean cross-sectional area (CSA1/2) of the pharyngeal airway space. Pearson’s correlation coefficient was used to find out whether there was a correlation between the change in CSA1/2 and the change in mandibular position, or the relative change between the mandibular position and the NHP. Volumes and minimal cross-sectional areas were increased in the pharyngeal airway space, and lengths of airways decreased. Correlation existed only between the increase in CSA1/2 and the relative change between the mandibular position and NHP. The increase in pharyngeal airway space after mandibular advancement correlated with the relative changes between the mandibular position and the NHP.

Purpose: The aim of this meta-analysis was to evaluate the efficacy of open surgery and closed treatment for unilateral moderately displaced mandibular condyle fractures. Methods: PubMed, Embase, and Cochrane Library databases were searched according to PRISMA guidelines from inception to October, 2018. Inclusion criteria were based on humans randomized controlled trials in the English literature. Pertinent data were collected and the incidence of the complications was calculated. Results: A total of 6 studies with 227 patients were included in the meta-analysis. The results showed that there were no significant differences in incidence of malocclusion (odds ratio [OR], 0.33; 95% confidence interval [CI]: 0.07–1.46; P = 0.14). However, open surgery group had a better maximal mouth opening (WMD = 3.82, 95% CI: 1.93–5.71, P < 0.01), protrusion (WMD = 1.16, 95% CI: 0.42–1.89, P < 0.01) and sum of both laterotrusions (WMD: 2.50, 95% CI: 1.77–3.22, P < 0.01). And the incidence of temporomandibular joint pain was lower than closed treatment group (OR: 0.15, 95% CI: 0.06–0.37, P < 0.01). Conclusions: Compared with closed treatment, open surgery has significant advantages in improving mouth opening and mandibular movement, and reducing the incidence of temporomandibular joint pain, provided that open surgery was a promising application in treatment of unilateral moderately displaced mandibular condyle fractures.

This pilot study aimed to investigate the feasibility of trans?oral ultrasonography of the temporomandibular joint (TMJ) in oblique sagittal plane. Six volunteers who were receiving residency training at Hainan Hospital of General Hospital of Chinese PLA were recruited into this study, five of them had normal TMJ and one had anterior displaced disc all of which had been confirmed by MRI. A hockey?stick?shaped ultrasound probe was placed between the cheek and maxilla to push against the mucosa lateral to posterior maxillary tuberosity, and every volunteer underwent bilateral scans. The sonographic imaging were completed successfully on the six volunteers; the condyle, the superior and the inferior head of the lateral pterygoid muscle, the disc and the maxillary vein were clearly identified in all the twelve ultrasonographic scans. The feasibility of trans?oral ultrasonography of TMJ in oblique sagittal plane was confirmed.

报道1例通过计算机辅助设计实施髁突肿瘤切除、同期用三维打印钛假体修复髁突缺损并随访两年的患者.患者女性,50岁,术前诊断倾向于低度恶性髁突肿物.将术前CT数据导入计算机辅助设计软件,确定截骨位置后设计截骨导板及髁突假体,三维打印钛合金截骨导板和髁突假体.术中截骨导板就位可靠,髁突肿瘤及其累及的关节囊和关节盘完整切除.术后病理诊断为左侧髁突软骨肉瘤.术后随访两年肿瘤未复发;患者咬合关系稳定,下颌运动无明显障碍;植入物未见排异反应,初步证实三维打印钛假体修复髁突缺损临床可行.

目的 了解海南省三亚市居民食用槟榔习惯的流行情况和口腔相关疾病发病情况.方法 2016年1月-2017年1月采用分层随机抽样的方法对三亚市居民食用槟榔情况调查,内容主要包括人口学基本特征、食用槟榔的方式及习惯,口腔发病情况等,并进行流行病学分析.结果 共调查545位城区居民和392位乡村居民,问卷有效率.91.6％,总体槟榔食用率41.8％,其中城区槟榔食用率为33.0％,乡村食用率为54.1％;食用槟榔年限城区5年以下占23.3％,乡村5年以下占16.5％;城区居民合并抽烟习惯占43.9％,乡村居民单独食用槟榔占42.5％;城区居民食用槟榔最主要原因为提神缓解疲劳,乡村居民最主要原因为成瘾,城区与乡村食用槟榔原因差异有统计学意义(P＜0.05);在食用槟榔人群中,色素沉着、口腔粘膜下纤维化、牙齿磨耗三种疾病最为常见,多因素Logistic回归分析结果显示食用槟榔人群中乡村比城区更易患口腔疾病,并且随每日食用槟榔量的增加,食用年限、单次食用时间的延长,罹患口腔疾病的风险相应增加(OR=0.739、0.345、和0.586).结论 三亚市居民食用槟榔已成为当地居民一种生活嗜好,食用人群具有年轻化,喜食新鲜槟榔,食用年限长,日食用量大的特点,而且长时间大量食用槟榔与多种口腔疾病的发生密切相关.

The utility model provides a go up jaw operation with cheek tractive ware, including tractive ware head (1), reverse drag hook portion (2), forward drag hook portion (3), handle portion (4), handle (4a), recess (4b). Cheek tractive ware is the blunt stick of edge circle, tractive ware head (1) supports in last jaw rear portion maxillary tuberosity or sphenoid bone pterygoid process department, inthe time of firm, laborsaving, avoids the damage to go up the wing clump at jaw rear, reverse drag hook portion (2), forward drag hook portion (3) suit with last jaw rear portion and lip cheek soft tissue appearance respectively, when fully exposing the jaw operation field of vision, avoid damaging lip cheek soft tissue, there is the recess in handle portion (4) surface, increases when gripping and the frictional force of palm to the convenience grips for a long time. The utility model discloses an economy and social for going up the operation of jaw rear portion the time exposes the operationfield of vision, when fully exposing the jaw rear portion operation field of vision, does not have the tractive lip cheek soft tissue of creating, stabilize, simple structure, convenient to use, havefine .

Our aim was to assess the accuracy of computer-aided orthognathic surgery for maxillary repositioning in 15 patients with mandibular hyperplasia and normal temporomandibular joints (TMJ). We aligned preoperative and postoperative virtual skulls at the cranium using surface superimposition then recorded and calibrated three 3-dimensional coordinates (maxillary dental landmarks U0, 6R, and 6L) on the skulls. Errors between these preoperative and postoperative landmarks were calculated and the largest error of every patient was chosen for assessment. Landmark errors ranged from 1.00 - 2.49mm, and recording errors from -0.06 - 0.07mm. The superimposition error was mean (SD) 0.036 (0.002)mm. The accuracy of the method is acceptable in patients with a normal TMJ.

The authors aimed to test the hypothesis that in orthognathic surgery the maxilla could be repositioned using spatial distances from Glabella to 3 maxillary dental landmarks as references. An asymmetric skeletal Class 3 malocclusion patient was involved and bimaxillary orthognathic surgery was planned. Virtual surgery was simulated and spatial distances from Glabella to midpoint of the upper dentition (U0) and bilateral medial-buccal cusp of the first molar (6L and 6R) were measured. These distances were used as the repositioning references and were imported intraoperatively into a digital caliper after the maxilla was mobilized, the repositioning of maxilla was manipulated till all the true spatial distances reached the references. Postoperative computed tomography head model were superimposed onto the planned head model, the maxillary repositioning error was assessed using spatial distances between the pre-and postoperative dental landmarks. The asymmetric skeletal Class 3 malocclusion was corrected through bimaxillary surgery and the errors at U0, 6R and 6L was 1.37, 1.79, and 1.45 mm. The maxilla could be repositioned using spatial distances from Glabella to 3 maxillary dental landmarks as references.

PURPOSE:To evaluate the effect of open and closed treatment of unilateral mandibular condyle fractures using meta-analysis.METHODS:Databases as the Cochrane Library,PubMed,Embase,CNKI,CBM,VIP,and Wanfang Data were searched from inception to September 25,2015.All randomized clinical trials (RCTs) on treatment of unilateral mandibular condyle fractures were collected,and then selected on the basis of the inclusion and exclusion criteria.The data were extracted from the included articles and meta analysis was performed using RevMan5.3.RESULTS:A total of 5 RCTs involving 197 patients were included and analyzed.The results of meta analysis showed that the maximal mouth opening (WMD:5.60,95％ CI:4.42-6.77,P＜0.01),protrusion (WMD:1.30,95％ CI:0.35-2.25,P＜0.01) and sum of bilateral laterotrusions (WMD:2.50,95％ CI:1.77-3.22,P＜0.01) of open surgery were significantly higher than conservative treatment.The incidence of temporomandibular joint pain was significantly lower than conservative treatment (OR:0.14,95％ CI:0.04-0.43,P＜0.01).There was no significant difference in incidence of malocclusion between the 2 groups (OR:0.33,95％ CI:0.07-1.46,P＞0.05).CONCLUSIONS:Compared with conservative treatment,open surgery has significant advantages in improving mouth opening and mandibular movement,and reducing the incidence of joint pain.