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Long term survival of mature autotransplanted teeth in 41 consecutive cases LU Li-rong, DING Xu, LIU Yu-chan China Journal of Oral and Maxillofacial Surgery    2021, 19 (4): 354-357.   DOI: 10.19438/j.cjoms.2021.04.013 Abstract （1627）      PDF （658KB）（310）       Knowledge map    PURPOSE: To investigate the long term survival of mature autotransplanted teeth, so as to provide reference for clinical application. METHODS: The clinical data of 41 patients (46 teeth) who underwent mature autotransplanted teeth were retrospectively analyzed. All patients were followed up regularly for clinical examination and X-ray examination. The 5-year cumulative survival rate and cumulative success rate of all implantations were analyzed. Digital X-ray film was used to detect the lesions, then the effects of gender, age and root canal therapy on the cumulative survival rate and success rate of implantations were analyzed with SPSS 19.0 software package. RESULTS: During the 5-year follow-up period, the cumulative survival rate was 84.78% (39/46), and the cumulative success rate was 71.74% (33/39). The lesions were detected in 10 of the 46 mature autotransplanted teeth, with a detection rate of 21.74%. The effect of root canal treatment showed significant impact on the cumulative success rate of mature autotransplanted teeth(P<0.05). CONCLUSIONS: The 5-year cumulative survival rate and cumulative success rate of mature autotransplanted teeth are relatively high, so it can be used in restoration of dentition defect; moreover, root canal therapy after implantation can effectively improve the success rate. Reference | Related Articles | Metrics

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Chinese Expert consensus on the diagnosis, treatment of odontogenic keratocyst LIU Bing, HE Yue, PENG Xin, SUN Chang-fu, HAN Zheng-xue, WU Yu-nong, PENG Li-wei, ZHAO Yi, TAO Qian, HAN Xin-guang, LI Jin-song, SU Tong, LI Bo, ZHANG Lei, HU Yan-ping, CHEN Chuan-jun, LI Yi, LI Tie-jun, ZHAO Yi-fang China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 209-218.   DOI: 10.19438/j.cjoms.2022.03.001 Abstract （1509）      PDF （1176KB）（611）       Knowledge map    Odontogenic keratocyst (OKC) is a common cystic lesion of the jaw. The nomenclature and nature of OKC remain controversial as a result of its local invasive behavior and high tendency of recurrence, which is evidently different from other types of jaw cysts. With the in-depth study of OKC pathogenesis and the advance of treatment concept and surgical techniques, it becomes possible to reduce the rate of postoperative recurrence and simultaneous functional reconstruction of the jaw. To establish standard diagnosis and treatment algorithms or guidelines of OKC, we organized peer experts in China to reach a consensus on pathogenesis, clinical manifestations, imaging characteristics, histopathological features, surgery and postoperative follow-up strategies of OKC for the references of clinicians. Reference | Related Articles | Metrics

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Efficacy of I.lanceolatum injection on postoperative reaction following dental implant surgery ZHU Qing-qing, SUN Qiang, WANG Dong-ling, ZHOU Hong China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 230-234.   DOI: 10.19438/j.cjoms.2022.03.004 Abstract （1190）      PDF （607KB）（77）       Knowledge map    PURPOSE: The aim of this study was to explore the effects of i.lanceolatum injection on postoperative reaction , following the placement of dental implants with guided bone regeneration(GBR). METHODS: Ninety patients requiring dental implants with GBR were included in this randomized controlled clinical trial. The patients were evenly divided into 3 groups. I.lanceolatum injection was adopted in the experimental group after surgery, dexamethasone injection was adopted in the control group, and patients didn't receive any injection in the blank group. Postoperative pain, swelling, early wound healing, and satisfaction were analyzed and evaluated after follow-up appointments at day 1, day 3, and day 7. SPSS 25.0 software package was used for data analysis. RESULTS: The experiment group had significantly lower pain and swelling indices than the blank group at day 1 and 3(P<0.05); it also had higher wound healing indices than the blank group at day 1 and 3(P<0.05). Operative satisfaction indices of the experimental and control group were significantly higher than the blank group(P<0.05). CONCLUSIONS: Postoperative adverse reactions can be improved by using i.lanceolatum injection following dental implant surgery with GBR. Reference | Related Articles | Metrics

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Mechanism of EGFR-targeted drugs for pain relief in oral cancer WEI Dong-liang, LI Zhi, JU Hou-yu, WU Yun-teng, GUO Wei, REN Guo-xin China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 219-224.   DOI: 10.19438/j.cjoms.2022.03.002 Abstract （1114）      PDF （907KB）（226）       Knowledge map    PURPOSE: The purpose of this study was to investigate whether drugs targeting EGFR (erlotinib, Nimotuzumab) could affect the pain threshold of experimental animals and to preliminarily explore the mechanism. METHODS: Naive mice were divided into two groups(physiological saline, n=6; erlotinib, n=6), the difference of pain threshold between the two groups was compared by Von Frey fiber test, hot plate test and 5% formalin test 1 h after administration. Nude mice were selected and divided into 3 groups (Sham + NS group, n=10; Plantar neoplasia + NS group, n=10; Plantar neoplasia + Nimotuzumab group, n=10). The mechanical pain threshold and thermal pain threshold of the mice were detected 1d before modeling and 1, 5, 7, 10 and 14 d after modeling. The mouse feet were dissected 14 days later, and the concentrations of IL-1β and IL-6 were detected by ELISA after tissue homogenization. The data were processed by Graphpad Prism statistical software. RESULTS: After erlotinib injection, the mechanical pain threshold and thermal pain threshold of mice had no obvious changes. After injection of 5% formalin in mice, the duration of licking in the anterior phase (0-10 min, P<0.01) and posterior phase (10-60 min, P<0.01) decreased significantly. Heat and mechanical pain sensitivity could be induced after plantar tumor formation in nude mice. Nimotuzumab slowed down tumor growth rate and increased thermal pain threshold (P<0.05) and mechanical pain threshold (P<0.05) in plantar tumorigenic mice. ELISA showed that the concentration of IL-1β (P<0.05) and IL-6 (P<0.05) in the plantar tissue of mice in the Nimotuzumab treatment group was significantly lower than that of the PBS treatment group. CONCLUSIONS: Erlotinib can alleviate pain induced by formalin in mice. Nimotuzumab can reduce mechanical and thermal pain sensitivity induced by plantar tumor formation, and the mechanism may be related to the decrease of inflammatory cytokines in local tissues. EGFR-targeted drugs may be one of the good analgesics for patients with advanced cancer pain. Reference | Related Articles | Metrics

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Clinicopathological characteristics and prognostic analysis of oral squamous cell carcinoma with parotid lymph node metastasis LI Xing, XU Fei-hu, YANG Yun-bo, HAN Nan-nan, RUAN Min China Journal of Oral and Maxillofacial Surgery    2022, 20 (1): 28-31.   DOI: 10.19438/j.cjoms.2022.01.005 Abstract （1040）      PDF （717KB）（146）       Knowledge map    PURPOSE: To investigate the clinical regularity of oral squamous cell carcinoma(OSCC) with parotid lymph node metastasis and its influence on prognosis. METHODS: A retrospective analysis of the clinicopathological data of 60 oral squamous cell carcinoma patients with or without parotid lymph node metastasis admitted to Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from January 2003 to December 2017 was conducted. SPSS 23.0 software package was used for data analysis. RESULTS: Primary tumor T stage(P=0.022) and cervical lymph node status(N stage, P=0.008) were closely related to parotid lymph node metastasis. Parotid metastatic lymph nodes were mostly located in the lower pole of the superficial parotid gland and prone to extracellular invasion(P<0.05). Parotid gland lymph node metastasis is closely related to the prognosis of oral squamous cell carcinoma(P=0.0004), and the 5-year survival rate of gingival squamous cell carcinoma with parotid lymph node metastasis was significantly higher than that of tongue squamous cell carcinoma(P=0.0427). CONCLUSIONS: Parotid lymph node metastasis is a poor prognostic factor for oral squamous cell carcinoma. Higher T and N stages are two important factors that promote LN metastasis to parotid gland in OSCC patients. Reference | Related Articles | Metrics

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Neoadjuvant immunotarget therapy in patients with locally advanced oral squamous cell carcinoma: report of 2 cases and literature review ZHANG Yi-yi, YANG Yue-yi, JU Wu-tong, ZHONG Lai-ping China Journal of Oral and Maxillofacial Surgery    2022, 20 (4): 413-416.   DOI: 10.19438/j.cjoms.2022.04.018 Abstract （902）      PDF （938KB）（83）       Knowledge map    Neoadjuvant therapy is systemic therapy before local treatment in patients with non-distant metastatic malignancies, aiming to reduce tumor load and distant metastasis, increase opportunity of radical resection, and relieve symptoms, et al. In this report, we presented two patients with locally advanced oral squamous cell carcinoma, who were treated with camrelizumab and apatinib as neoadjuvant therapy in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, and reviewed and discussed the relevant literatures. Reference | Related Articles | Metrics

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Prognostic factors of oral tongue squamous cell carcinoma: a retrospective study of 638 cases YE Chen, CAI Yun, ZHAO Xiao-mei, ZHANG Chen-ping, ZHAO Nai-qing China Journal of Oral and Maxillofacial Surgery    2021, 19 (5): 449-455.   DOI: 10.19438/j.cjoms.2021.05.012 Abstract （852）      PDF （4620KB）（224）       Knowledge map    PURPOSE: To investigate the impact of clinical and pathological characteristics on survival of patients with oral tongue squamous cell carcinoma （OTSCC）, and to analyze the factors predicting survival outcome. METHODS: A retrospective analysis of 638 patients diagnosed with OTSCC at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2003 to December 2013 was performed. Details on patient characteristics and tumor characteristics were recorded by retrospective review of patients' charts. Survival data acquisition was retrieved from Shanghai registry database of resident cancer by Shanghai Center for Disease Control and Prevention. Standard descriptive statistics were used to summarize patient demographic and disease-related data. Pearson Chi-square, Kaplan-Meier, Log-rank test, and Cox proportional hazards regression analysis were performed with Stata/SE 10.0 software package, and only variables with P<0.05 in univariate analysis were included in multivariable regression models. RESULTS: The 1-year, 3-year, and 5-year overall survival of 638 patients were 83.52%, 68.98% and 63.33%, respectively. Univariate analysis indicated that age> 60 years, males below 60 years, base of tongue, higher T stage, N stage were predictors of poor outcome. In multivariate analysis, several predictors of compromised overall survival were T stage, N stage and histopathological grade. T stage and N stage were strong independent predictors of poorer overall survival. CONCLUSIONS: Age, sex, lesion, T stage, N stage and histopathologic grading are prognostic factors for OTSCC patients. Reference | Related Articles | Metrics

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Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas(version 2022) ZHENG Jia-wei, WANG Xu-kai, QIN Zhong-ping, FAN Xin-dong, LI Kai, YANG Yao-wu, HUO Ran, LIU Shao-hua, ZHAO Ji-hong, WANG Xiao-yong, ZHOU De-kai, LIU Xue-jian China Journal of Oral and Maxillofacial Surgery    2022, 20 (4): 313-319.   DOI: 10.19438/j.cjoms.2022.04.001 Abstract （803）      PDF （1061KB）（647）       Knowledge map    Since 2008, propranolol has become the first-line treatment for infantile hemangiomas. Many researches have been reported on its treatment mechanism both at home and abroad, and several expert consensus or clinical practice guidelines have been formulated and published. In recent years, with the continuous accumulation of clinical experience, increasing number of basic research works, and deepening understanding of the pathogenesis of hemangioma and the mechanism of action of propranolol, it is necessary to update the expert consensus to be more consistent with clinical practice, in order to guide medication and management, provide scientific norms for the clinical use of propranolol in the treatment of infantile hemangiomas. This updated version mainly simplified the process of clinical examination, medication, and monitoring, making it more convenient and operable. Reference | Related Articles | Metrics

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Comparative study of four trauma scoring systems to evaluate maxillofacial fractures CHEN Chen, SUN Ning-ning, HE Yang, AN Jin-gang, GONG Xi, ZHANG Yi China Journal of Oral and Maxillofacial Surgery    2021, 19 (4): 350-353.   DOI: 10.19438/j.cjoms.2021.04.012 Abstract （798）      PDF （433KB）（231）       Knowledge map    PURPOSE: To select a scoring system suitable for scoring of maxillofacial trauma by comparing the effects of four commonly used trauma scoring systems. METHODS: This study cohort comprised 1 009 patients with maxillofacial trauma from January 2008 to December 2013 at Peking University School and Hospital of Stomatology. There were 46 cases with simple maxillary fractures, 536 cases with simple mandibular fractures, 233 cases with simple zygomatic arch fractures, and 194 cases with compound fractures. New Injury Severity score (NISS), Facial Injury Severity Score (FISS), Maxillofacial Injury Severity Score (MFISS), and Maxillofacial Injury Severity Score (MISS) were used to grade the injury severity of the patients before surgery. The data were imported into SPSS 21.0 software package. Correlation coefficients between the results of the four scoring systems and clinical effective indexes were calculated by non-parametric correlation analysis. Multivariate linear regression analysis was carried out with length of stay and hospitalization expenses as dependent variables. RESULTS: There was no significant difference between the score of mandibular fracture and zygomatic fracture by NISS. When FISS, MFISS, and MISS were applied, there was no significant difference between maxillary fracture scores and mandibular fracture scores(P>0.05). NISS, FISS, MFISS and MISS were positively correlated with operation time, cost of anesthesia, length of hospitalization stay, and correlation coefficients of MFISS were the highest(0.475,0.485, 0.434). The difference was statistically significant(P<0.05). Trauma score and concomitant injury were positively significant influencing factors of length of hospital stay and hospitalization expenses(P<0.05). CONCLUSIONS: MFISS showed the highest correlation with clinical effective indexes, and affected the length of hospital stay and hospitalization expenses significantly. MFISS reflected the injury severity of maxillofacial trauma better. Reference | Related Articles | Metrics

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Application of ultrasound assisted parotid flap sialolithotomy for deep parotid stones: report of 5 cases JIN Zhi-lei, LIU Wei-jun, WU Guo-rong, ZHOU Qin, SHI Huan China Journal of Oral and Maxillofacial Surgery    2022, 20 (1): 77-80.   DOI: 10.19438/j.cjoms.2022.01.015 Abstract （705）      PDF （724KB）（109）       Knowledge map    PURPOSE: To explore the clinical value of ultrasound-assisted parotid flap sialolithotomy in the treatment of deep parotid duct stones. METHODS: From January 2019 to June 2020, five patients with deep parotid duct stones in the Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, were collected. Preoperative CT scan showed that the stones were located in the intraparenchymal duct, which was at the anterior edge of the masseter muscle. The patient underwent parotid flap stone extraction under general anesthesia. During operation, a small S-shaped incision was designed behind the ear with the aid of B-ultrasound. The marginal mandibular branch of the facial nerve was dissected to expose the duct in the gland where the stone was located. Then, the wall of the duct wall was cut to remove the stone, and the duct was sutured tightly. Follow-up data were collected at 1 week, 3 months, and 12 months after operation. RESULTS: All stones were successfully removed. One patient developed symptoms of parotid duct obstruction after operation, which improved after washing and dilatation treatment. No facial nerve injury, salivary fistula, infection and other complications occurred. The clinical symptoms before surgery were completely relieved at 12-month follow-up, and the curative effect was satisfactory. CONCLUSIONS: Ultrasound-assisted parotid flap sialolithotomy for deep parotid duct stones has a high success rate, good curative effect, and is worth of wide application. Reference | Related Articles | Metrics

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A clinical analysis of 279 patients with submucous cleft palate DU Chang-jiang, ZHOU Xia, MA Lian China Journal of Oral and Maxillofacial Surgery    2021, 19 (5): 464-468.   DOI: 10.19438/j.cjoms.2021.05.015 Abstract （618）      PDF （3626KB）（187）       Knowledge map    PURPOSE: To analyze the data collected from medical records for 279 submucous cleft palate patients which included age of operation, reasons for admitting into hospital and accompanied diseases. METHODS: A retrospective study was conducted on 279 patients receiving treatment for submucous cleft palate from 2013.01.01 to 2020.12.31 in Peking University Hospital of Stomatology. The following items from medical records were collected: age of operation, reasons for admitting into hospital and the types of accompanied diseases (cleft lip, well-known syndromes, chromosomal diseases, hearing impairment and intelligence retardation). The reasons for admitting into the hospital were divided into three types: speech problem, morphological abnormality on hard and/or soft palate, and others. RESULTS: The average age of operation on submucous cleft palate patients in this cohort was 5 years and 5 months and the median age was 4 years and 2 months old. Age range was from 6 months to 35 years and 2 months. Cleft lip occurred in 34(12.2%) patients, and 15 (5.4%) patients suffered from well-known syndromes. Regarding to the reasons for admitting into hospital, 194(69.5%) patients were due to unclear speech. Morphological abnormality of hard and/or soft palate occurred in 52(18.6%) and 33 (11.9%) patients were due to other reasons for medical treatment. CONCLUSIONS: The operation age of patients with submucous cleft palate was significantly later than cleft palate patients. Patients with cleft lip accounted for more than half of patients with accompanied diseases. More than half of patients with submucous cleft palate admitted into hospital were due to speech problems. Reference | Related Articles | Metrics

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Comparison of the effect of two kinds of biopsy on prognosis of oral mucosal malignant melanoma - a retrospective analysis of156cases HAN Ru-xue, MA Xu-hui, LI Zhi, REN Guo-xin, GUO-Wei, WU Yun-teng, LIANG Xiang China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 235-238.   DOI: 10.19438/j.cjoms.2022.03.005 Abstract （618）      PDF （682KB）（92）       Knowledge map    PURPOSE: To compare the effect of two kinds of biopsy on prognosis of oral mucosal malignant melanoma (OMM), in order to find an optional biopsy method for OMM. METHODS: Patients with OMM treated at Shanghai Ninth Hospital, Shanghai Jiao Tong University School of Medicine from Jan.2010 to Jan.2018 were retrospectively analyzed. Correlation between biopsy methods and prognosis were explored. Overall survival (OS) was the primary outcome, and OS was the time from pathological diagnosis to the date of death or follow-up (September 1, 2021). SAS 9.3 software was used for statistical analysis. RESULTS: Univariate analysis showed that T stage, cervical lymph node(CLN) status, biopsy type and OS were statistically correlated. All the three variables were included in Cox regression model for multivariate analysis. The results showed that T stage, CLN and biopsy type were independent prognostic factors of OS(P<0.05). CLN and biopsy methods were identified as prognostic factors. Incidences of CLN and distant metastasis were both significantly less in cryogenic biopsy group than in incisional biopsy group (53% vs. 74% and 22% vs. 42%, Log-rank=12.955, P<0.01 respectively). The 3- and 5-year OS was significantly longer in cryogenic biopsy group than in incisional biopsy group (65% vs. 42%,Log-rank=12.570, P<0.01 and 54% vs. 20%, Log-rank=7.203, P<0.01, respectively). CONCLUSIONS: The 3- and 5- year OS in cryogenic biopsy group was significantly better than that in the incisional biopsy group. Cryogenic biopsy could significantly reduce CLN and distant metastasis of OMM. Therefore, Use of cryogenic biopsy instead of incisional biopsy to clarify the diagnosis of OMM is recommended. Reference | Related Articles | Metrics

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Chinese expert consensus statement on the application of of indocyanine green(ICG) fluorescence imaging in the treatment of oral squamous cell carcinoma WANG Yu-xin, WANG Zhi-yong, WANG Yong-gong, WANG Hui-ming, WANG Li-zhen, TIAN Hao, YE Jin-hai, FU Kun, RUAN Min, SUN Chang-fu, SUN Guo-wen, LIU Fa-yu, XU Bi-yun, HOU Jun, LIU Bing, LIU Liang, CHEN Yong-feng, CHEN Zhan-wei, XIAO Can, LI Si-yi, LI Zhi-yong, LI Yong, LI Nan, ZHANG Chen-ping, ZHANG Dong-sheng, ZHANG Sheng, ZHANG Kai, YANG Xi, HE Wei, SU Tong, JI Tong, LIN Li-song, LUO Rui-hua, ZHAO Zhi-li, HU Qin-gang, TANG Zhan-gui, XU Wei-jia, HUANG Zhi-quan, HUANG Xiao-feng, LIANG Yu-jie, HAN Zheng-xue, HAN Wei, JIANG Can-hua, YU Jian-jun, CAI Zhi-gang, LIAO Gui-qing, LIAO Sheng-kai, CAI Hui-ming, WEI Jian-hua China Journal of Oral and Maxillofacial Surgery    2022, 20 (1): 1-6.   DOI: 10.19438/j.cjoms.2022.01.001 Abstract （576）      PDF （847KB）（308）       Knowledge map    Indocyanine green (ICG) is a near-infrared fluorescent dye. Based on the enhanced permeability and retention (EPR) effect, the ICG fluorescence imaging was applied extensively in biomedical fields. The technique could sensitively detect imaging difference between the tumor and surrounding tissue, and define the tumor border to assist in tumor resection. Nevertheless, the application in the treatment of oral squamous cell carcinoma (OSCC) is still at the neonate stage. Thereby, its indication, standard operation procedure and caution required normalization. On the Evidence-based approaches including multi-center study, systemic reviews of related scientific publications,the Chinese experts reach a consensus of ICG fluorescence imaging technique to instruct the clinical practice of OSCC surgery. Reference | Related Articles | Metrics

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Expert consensus on application of submental island flap in oromaxillofacial head and neck defect reconstruction CHEN Chuan-jun, CHEN Wei-liang, SUN Chang-fu, HE Yue, JIANG Can-hua, PENG Xin, SHANG Zheng-jun, HAN Zheng-xue, LI Jin-song, HOU Jin-song, LIN Li-song, HAN Xin-guang, WEI Jian-hua, WANG Zhi-yong, WU Yu-nong, ZHENG Jia-wei, LI Long-jiang, WANG Hui-ming, LI Zu-bing, GUO Chuan-bin, YANG Chi, SHI Bing, ZHANG Zhi-yuan China Journal of Oral and Maxillofacial Surgery    2021, 19 (5): 385-391.   DOI: 10.19438/j.cjoms.2021.05.001 Abstract （570）      PDF （5968KB）（442）       Knowledge map    Submental island flap (SMIF) is an axial flap that receives its blood supply from the submental artery, a branch of the facial artery. It is in close proximity with many oral and maxillofacial regions, and provides a good texture and color match. The flap is easy to prepare and suitable for repairing medium-sized defects of the oral and maxillofacial region with high survival rates. However, there are still controversies about the application of submental island flap both at home and abroad, mainly focusing on the oncological safety of submental island flap for patients with cervical lymph node metastasis and the preparation method of the flap. In order to unify and standardize the application of submental island flap in repair of oral and maxillofacial head and neck defects, this paper focuses on the collective wisdom of experts in oral and maxillofacial surgery of many medical colleges in China, and reaches an expert consensus, so as to guide the clinical application of submental island flap. Reference | Related Articles | Metrics

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Sialadenoma papilliferum：a clinicopathologic study of one case HAN Lin-zi, FANG Yi-kang, YU Wen-yi, WANG Qi-min, TONG Lei, QIU Jian-zhong, YUAN Rong-tao China Journal of Oral and Maxillofacial Surgery    2022, 20 (1): 98-100.   DOI: 10.19438/j.cjoms.2022.01.019 Abstract （552）      PDF （819KB）（178）       Knowledge map    Sialadenoma papilliferum（SP） is a kind of rare benign tumor of salivary glands without pain and showing a characteristic papillary growth, it was classified as a ductal papilloma in the WHO's latest tumor classification. The lesions mainly affect the minor salivary glands and the most common site was the palate. The purpose of this paper was to describe a case of sialadenoma papilliferum occurring in mandibular retromolar region and discuss its clinical features and histopathology. Reference | Related Articles | Metrics

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Expert consensus on diagnosis and clinical management of medication-related osteonecrosis of the jaw HE Yue, CHEN Heng, AN Jin-gang, GUO Yu-xing, PAN Jian, TIAN Lei, LIU Bing, HOU Jin-song, LI Jin-song, JIANG Can-hua, LI Meng-yu, TIAN Zhen, XU Jie, ZHU Ling, SUN Chang-fu, ZHI Ke-qian, QU Qing, ZONG Chun-lin, SUN Jing-jing, ZHANG Zhi-yuan China Journal of Oral and Maxillofacial Surgery    2023, 21 (4): 313-325.   DOI: 10.19438/j.cjoms.2023.04.001 Abstract （543）      PDF （2051KB）（755）       Knowledge map    Medication-related osteonecrosis of the jaw(MRONJ) is a complication caused by the application of anti-resorptive medications, angiogenesis inhibitors, hormones and other medications for the treatment of some systemic diseases. The clinical symptoms include swelling, pain, masticatory disorders, persistent fistula, bone exposure and even pathological fracture, which seriously affect the patients' quality of life. Domestically, there is a lack of consensus or guidelines on classification, staging and treatment of MRONJ, and different institutions make diagnosis and treatment plans empirically. In order to unify and standardize the diagnosis and treatment of MRONJ and improve the prognosis, an expert panel of MRONJ research from 12 famous domestic medical colleges and affiliated hospitals convened a meeting to discuss the diagnosis and treatment opinions of MRONJ. Meanwhile, consensus recommendations were also revised with a comprehensive literature review of the previous treatment experiences and research findings. Finally, this expert consensus was finished for clinical references. Reference | Related Articles | Metrics

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Comparison of socket-shield technique and routine immediate implantation in anterior maxillary region YAO Chen-yang, MEI Dong-mei, TENG Min-hua, Xu Hao, WANG Wen-xue, LI Jing, ZHOU Chen, ZHAO Bao-dong China Journal of Oral and Maxillofacial Surgery    2021, 19 (6): 536-541.   DOI: 10.19438/j.cjoms.2021.06.010 Abstract （539）      PDF （1672KB）（181）       Knowledge map    PURPOSE: To compare the changes in the thickness of labial bone mass and clinical effects between socket-shield technique and routine immediate implant placement in the aesthetic area of anterior maxillary region, and discuss operation details of the socket-shield technique. METHODS: Forty-eight patients were included for immediate implantation between September 2017 to March 2019 in the Affiliated Hospital of Qingdao University. Of them, twenty-six patients underwent routine immediate implantation(RI group), while 22 patients received socket-shield technique(SS group). The follow-up periods were 18-36 months, and the following parameters were employed for comparison: implant success rate, the changes of labial bone plate at 0 mm (I0), 3 mm (I3) and 6 mm (I6) below the shoulder of the implant, the pink aesthetics index(PES) at the last follow-up, gingival sulcus bleeding index and clinical satisfaction. SPSS 25. 0 software package was used for data analysis. RESULTS: The success rate in both groups was 100%. At 6 months and 18 months after operation , the changes of labial bone plate in SS group were lower than those in RI group, with significant difference at I0 and I3. PES score in SS group was higher than that in RI group, but with no significant difference. There was no significant difference in the modified sulcus bleeding index between these two techniques, and both groups obtained high patient satisfaction. CONCLUSIONS: Compared with routine immediate implantation, socket-shield technique maintains bone mass in the labial side of the neck of the implant and soft tissue profile in a short period of time, but has no obvious effect on the success rate. However, these two methods still need long-term clinical observation. It is recommended to prepare root film to the level of the bone surface, with a thickness of about 1 mm,keep a gap of about 1-2 mm on the labial side of the implant and then fill the bone graft material into the defect site. Pitifully, this technique needs highly difficult requirement of clinical procedure. Reference | Related Articles | Metrics

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Imaging features of temporomandibular joint disorder: comparison of the efficacy of cone-beam CT, MRI CHEN Jian-rong, DING Shui-qing, CHEN Liang, HE Jia-jia, QI Rong-xing China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 273-276.   DOI: 10.19438/j.cjoms.2022.03.012 Abstract （537）      PDF （460KB）（156）       Knowledge map    PURPOSE: To analyze the features on cone-beam CT (CBCT) and MRI of temporomandibular joint disorder (TMD). METHODS: The data of 45 patients with TMD treated in Nantong Hospital of Stomatology from August 2018 to May 2020 were collected. All patients completed CBCT and MRI within 2 weeks, and the characteristics of TMJ and masticatory muscle lesions on CBCT and MRI were evaluated, including joint space stenosis, bone destruction, bone hyperplasia and sclerosis, condyle deformation, bone cystoid degeneration, articular disc displacement, joint capsule effusion and masticatory muscle lesions. SPSS 25.0 software package was used for data analysis. RESULTS: According to TMD clinical classification, 31 cases (68.9%) were classified as type I painful diseases, and 14 cases (31.1%) were classified as type II joint diseases. Among the 90 joints of 45 patients, the number of TMJ and masticatory muscle lesions detected by MRI (71/90) was significantly higher than the number of lesions detected by CBCT (58/90) (P=0.032). Among them, the number of articular disc displacement (19/90), joint capsule effusion (28/90) and masticatory muscle edema (22/90) were significantly higher than the number of cases detected by CBCT which was 3/90, 8/90 and 5/90 (P<0.001). The number of cases of hyperosteosis (18/90) and condyle mutation (15/90) detected by CBCT was significantly higher than the number of cases detected by MRI which was 8/90 and 6/90 (P<0.05). CBCT and MRI had no significant differences in detecting joint space stenosis, bone destruction and cystoid degeneration(P>0.05). CONCLUSIONS: Both CBCT and MRI have high clinical value in evaluating TMD. CBCT has advantages in evaluating bone quality, while MRI has a good effect in evaluating joint discs and soft tissues. Reference | Related Articles | Metrics

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Application and advancement of minimally invasive instruments and micro-power devices in tooth extraction LI Yan-xiang, YAN Li-jun, LING Xiao-wan, ZHOU Wen-jie, WANG Yue-ping China Journal of Oral and Maxillofacial Surgery    2023, 21 (2): 191-196.   DOI: 10.19438/j.cjoms.2023.02.016 Abstract （508）      PDF （914KB）（224）       Knowledge map    Tooth extraction is to remove the affected teeth that can no longer provide oral function, and it is also one of the most basic and common procedures in alveolar surgery. Conventional tooth extraction applies elevators, forceps, chisels and other instruments, which may cause severe physical and psychological trauma to the patient. In recent years, the concepts of minimally invasive tooth extraction has been accepted in the clinic, and the development of materials has led to more refined extraction instruments. Meanwhile the use of micro-power devices has greatly improved the efficiency of tooth extraction. Advancements in tooth extraction techniques and equipments are aimed to maximumly preserve the integrity of the alveolar bone, reduce the complications, and relieve the pain. This paper described the development of minimally invasive tooth extraction techniques through the evolution of instruments and the application of micro-power devices, so as to provide reference for more dentists to understand and apply minimally invasive equipments in daily practice. Reference | Related Articles | Metrics

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Expert consensus on clinical diagnosis and treatment for Chinese oral mucosal melanoma GUO Wei, REN Guo-xin, SUN Mo-yi, KONG Yun-yi, WANG Li-zhen, BU Rong-fa, RAN Wei, TANG Zhan-gui, LI Long-jiang, MENG Jian, SUN Zhi-jun, SHANG Wei, LV Jiong, WU He-ming, ZHANG Chen-ping, HE Yue, MA Xu-hui, SONG Hao, JU Hou-yu, ZHENG Jia-wei, GONG Zhong-cheng, YANG Kai, ZHANG Jie, WU Yun-teng China Journal of Oral and Maxillofacial Surgery    2021, 19 (6): 481-488.   DOI: 10.19438/j.cjoms.2021.06.001 Abstract （504）      PDF （1408KB）（500）       Knowledge map    [Summary] Head and neck mucosal melanoma (HNMM) is a kind of highly malignant solid tumor. The 5-year survival rate of HNMM is about 20% for a long time. Its pathogenic factors, driving genes, clinical manifestations and treatment methods are quite different from skin melanoma. In 2015, the first Chinese expert consensus on the diagnosis and treatment of head and neck mucosal malignant melanoma was established. After more than six years of application, the clinical diagnosis and treatment of HNMM has been greatly improved. With the deepening of clinical and basic research on mucosal melanoma, the diagnosis, treatment and prognosis of HNMM have changed greatly in recent years, especially with the vigorous development of various branches of head and neck. Oral, nasal, sinus, eye and other mucosal melanoma have developed their own unique diagnosis and treatment model. This consensus can’t meet the actual needs of the current clinical practice. In this regard, the expert group believes that head and neck mucosa contains a wide range of anatomy, involving more clinical departments, and the diagnosis and treatment mode of melanoma varies significantly between different disciplines. It is urgent to meet the clinical consensus of more specialized diagnosis and treatment of individualized treatment and precise treatment. In order to further improve the long-term survival rate and quality of life of oral mucosal melanoma (OMM) and make the consensus to better guide clinical work, this expert group will focus on OMM and conduct in-depth discussion, and establish expert consensus based on evidence-based medicine and empirical medicine. Considering the individual differences of patients, this consensus can be used as a reference for clinical practice of OMM. Reference | Related Articles | Metrics