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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 （550）      PDF （2051KB）（765）       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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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 （807）      PDF （1061KB）（657）       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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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 （1513）      PDF （1176KB）（614）       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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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 （1117）      PDF （907KB）（227）       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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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 （509）      PDF （914KB）（225）       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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Research progress of the effect of osteoporosis on dental implant restoration JIN Xia-yue, GU Yin-xin China Journal of Oral and Maxillofacial Surgery    2023, 21 (1): 81-86.   DOI: 10.19438/j.cjoms.2023.01.014 Abstract （186）      PDF （700KB）（189）       Knowledge map    Osteoporosis is a systemic bone metabolism disease that occurs in middle-aged and elderly people. The incidence of osteoporosis is increasing year by year with the increase of the elderly population. Meanwhile, with the progress of dental implant technology, more and more elderly people undergo implant restoration. Osteoporosis was once considered to be one of the risk factors for dental implant restoration, which may influence the initial stability and survival rate of implants, and drugs for osteoporosis treatment also inevitably affect the osseointegration of implants. This article reviewed relevant studies to summarize the impact of osteoporosis on dental implant restoration. Reference | Related Articles | Metrics

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Tongue base tumor, open surgery or transoral robotic surgery? XI Qing China Journal of Oral and Maxillofacial Surgery    2022, 20 (6): 527-533.   DOI: 10.19438/j.cjoms.2022.06.002 Abstract （391）      PDF （1307KB）（186）       Knowledge map    Tongue base tumors are common in oral and maxillofacial surgery. The anatomical location of tongue base tumor is deep and difficult to treat, there is no consensus on the choice of surgical treatment. This article aimed to summarize the research progress in tongue base tumors, analyze and compare the treatment methods, summarize their advantages and disadvantages, and provide reference for clinical diagnosis and treatment of tongue base tumors. Reference | Related Articles | Metrics

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Accuracy of detachable 3D-printed stent placement in radiotherapy for oral cancer patients FAN Wen-hui, LAO Zheng, SHI Hui-feng, BI Fan, TU Wen-yong, HU Hai-sheng China Journal of Oral and Maxillofacial Surgery    2022, 20 (5): 466-470.   DOI: 10.19438/j.cjoms.2022.05.009 Abstract （356）      PDF （908KB）（183）       Knowledge map    PURPOSE: To customize a detachable 3D-printed oral stent for patients with oral cancer radiotherapy, the stent was connected with thermoplastic film to improve the positioning accuracy of patients. METHODS: Twenty patients with oral cancer were randomly divided into control group and experimental groups, patients in the experimental group used detachable 3D-printed stents placement while patients in the control group used traditional 3D-printed oral stents. X1, Y1, Z1 direction of translation and X2, Y2, Z2 direction of rotating beam position error were obtained by cone-beam CT (CBCT) in patients before (1st radiotherapy), during (10th radiotherapy), and after radiotherapy (20th radiotherapy). The positioning errors of the third cervical spine and the horizontal ramus of the mandible were evaluated for clinical positioning errors. SPSS 23.0 software package was used for data analysis. RESULTS: The mean translational errors in X1, Y1 and Z1 directions were (0.120±0.083), (0.180±0.250), (0.170±0.150) cm in the control group, and (0.081±0.084), (0.047±0.059) , (0.046±0.036) cm in the experimental group. The difference was statistically significant in the Y1(t=2.4, P<0.05) and Z1(t=3.64, P<0.05) direction. The mean rotational positioning errors of X2, Y2 and Z2 were 1.04°±0.62°, 1.26°±1.30°, 0.65°±0.55° in the control group and 0.67°±0.73°, 0.54°±0.24°, 0.45°±0.37° in the experimental group. The difference was statistically significant in the direction of Y2(t=2.53, P<0.05). The displacement of the third cervical vertebra in the control group and the experimental group was (0.130±0.080) and (0.074±0.090) cm. The displacement at the end point of the horizontal ramus of the mandible was (0.240±0.180) cm in the control group and (0.095±0.065) cm in the experimental group, which had significant difference (t=2.99, P<0.05). CONCLUSIONS: Compared with traditional 3D printed oral stent, the detachable 3D printed oral stent can effectively improve the positioning accuracy and has a good clinical application prospect. Reference | Related Articles | Metrics

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Establishment and identification of patient-derived organoid model in head and neck squamous carcinoma WANG Chong, KANG Xin-dan, WANG Rui, WU Ya-ping, SUN Lu-lu, ZHANG Zhi-yuan, SUN Shu-yang China Journal of Oral and Maxillofacial Surgery    2022, 20 (4): 328-333.   DOI: 10.19438/j.cjoms.2022.04.003 Abstract （339）      PDF （2143KB）（180）       Knowledge map    PURPOSE: To construct and identify patient-derived organoid (PDO) model of head and neck squamous cell carcinoma(HNSCC). METHODS: Tumor cells, isolated from HNSCC samples, were cultured and passaged in matrix gel with three dimensions. The growth was also recorded at regular intervals. The correlation between patient tumor tissue and PDO models in histopathological and tumor molecular markers was compared using H-E and immunohistochemical staining assay. RESULTS: This study displayed 3 cases of PDO models that could be passaged stably, and the histopathology and tumor marker identification results showed that the model and the patient's tissues were consistent with each other. CONCLUSIONS: The PDO model constructed from samples of HNSCC could reflect the patient's histomorphology and biomarker characteristics, and could be utilized as a reliable preclinical model in the further HNSCC study. Reference | Related Articles | Metrics

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Prognostic factors of primary intraosseous squamous cell carcinoma: a retrospective review of98consecutive cases YANG Jin-gang, XIA Rong-hui, ZHU Yun, WU Si-cheng, DONG Ya-bing, YANG Gong-xin, SHI Jun-long, CUI Ying-hui, ZHU Ling, ZHOU Shang-hui China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 239-243.   DOI: 10.19438/j.cjoms.2022.03.006 Abstract （486）      PDF （529KB）（160）       Knowledge map    PURPOSE: To delineate the clinical and pathological features and determine the prognostic factors of primary intraosseous squamous cell carcinoma (PIOSCC). METHODS: The clinical, radiological, histopathological and postoperative follow-up data of patients diagnosed with PIOSCC in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from 2013 to 2017 were collected, and the prognostic factors of PIOSCC were analyzed by descriptive statistical methods. Baseline data were analyzed by univariate and multivariate survival analysis with SPSS 23.0 software package. RESULTS: A total of 98 patients with PIOSCC were enrolled, with a mean age of 56.6 years. Among them, there were 71 males and 27 females, and 33 in the maxilla, 65 in the mandible. Of the 95 patients followed up, 24 patients developed local recurrences and 10 patients developed distant metastases; furthermore, most local recurrences and distant metastasis occurred within 2 years after operation. The estimated 2-year and 5-year overall survival were 74.7% and 61.8%, respectively. Univariate analysis showed that tumor site, tumor size, positive margin, and cervical lymph node metastasis were significant prognostic factors for overall survival; facial numbness, positive margin were significant prognostic factors for local recurrences; and tumor site, cervical lymph node metastasis were significant prognostic factors for distant metastasis. Multivariate analysis showed that only positive margin and cervical lymph node metastasis remained as significant prognostic factors for overall survival. CONCLUSIONS: Recurrence, metastasis, and death occurred most frequently within 2 years after operation of PIOSCC. Positive margin and cervical lymph node metastasis were negative prognostic factors for PIOSCC. Reference | Related Articles | Metrics

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Progress on diagnosis and treatment of HPV-related oropharyngeal cancer WU Ya-ping, GAO Jia-min, SUN Shu-yang China Journal of Oral and Maxillofacial Surgery    2022, 20 (6): 599-606.   DOI: 10.19438/j.cjoms.2022.06.015 Abstract （389）      PDF （807KB）（160）       Knowledge map    The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been on the rise in recent years, and HPV infection is a critical risk factor for the occurrence of OPSCC. Due to its unique biological characteristics, sensitivity to chemoradiotherapy and good prognosis, HPV-related OPSCC has been classified as an independent disease in the 2017 AJCC and WHO staging system. However, there is no obvious difference in the clinical treatment of patients with HPV-related or non-related OPSCC. Therefore, search for a more suitable treatment plan for patients with HPV-related OPSCC has become a hot spot of current concern. This article reviewed the recent advances in the diagnosis and treatment of HPV-related OPSCC. Reference | Related Articles | Metrics

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Application and research advance of deep learning in the diagnosis and treatment of dento-maxillofacial deformities TAO Le-ran, ZHANG Rong-bin, LIN Yu-xin, LING Zong-xiang, CHENG Meng-jia, YU Hong-bo China Journal of Oral and Maxillofacial Surgery    2022, 20 (4): 405-409.   DOI: 10.19438/j.cjoms.2022.04.016 Abstract （354）      PDF （673KB）（157）       Knowledge map    Digital technology provides an ideal auxiliary method for the diagnosis and treatment of dento-maxillofacial deformities. However, due to technical limitations, current digital orthognathic surgery has problems such as semi-automated image processing and insufficient utilization of 3D images. The urgent need for clinicians to improve efficiency and optimize the diagnosis and treatment has prompted a series of researches on deep learning-assisted diagnosis and treatment of dento-maxillofacial deformities, which demonstrated the great potential of applying deep learning in this field. Therefore, this paper reviewed the development history of interdisciplinary researches between deep learning and medicine at first, and then focused on the application and research advance of deep learning in the diagnosis and treatment of dento-maxillofacial deformities, and furthermore exploring the intelligent diagnosis and treatment. 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 （540）      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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Synthesis of carbon dots with dual roles of osteogenic and antibacterial effects for infected bone defects treatment LIU Yi-ge, WANG Zi-lin, GUO Zhi-yong, WU Hao, WANG Wen-ying, HAN Jing, LIU Jian-nan, ZHANG Chen-ping China Journal of Oral and Maxillofacial Surgery    2023, 21 (1): 11-18.   DOI: 10.19438/j.cjoms.2023.01.002 Abstract （194）      PDF （2337KB）（155）       Knowledge map    PURPOSE: To investigate the effects of a new kind of carbon dots (CDots) made from gentamicin and folic acid on osteogenic differentiation and autophagy of rat bone marrow stromal cells (BMSCs), as well as the inhibition of common oral pathogenic bacteria. METHODS: CDots were prepared by hydrothermal method using gentamicin and folic acid as raw materials, and characterized by transmission electron microscopy and UV spectrophotometer. Biocompatibility was evaluated by CCK-8 assay and apoptosis assay, and uptake by cells was observed by laser confocal microscopy. Alkaline phosphatase staining and alizarin red staining were used to detect the effect on osteogenic differentiation of BMSCs. Real-time quantitative PCR was performed to detect the mRNA expression levels of osteogenic and autophagy-related genes. Scanning electron microscopy and plate colony assay were performed to observe the ability of CDots to inhibit Porphyromonas gingivalis and Fusobacterium nucleatum. Graph Pad Prism 9 software was used for statistical analysis. RESULTS: The CDots solution emitted blue fluorescence under UV light irradiation with a UV absorption peak at 330 nm; the PL emission peak of CDots was concentrated at 440 nm under the excitation of 405 nm laser. Transmission electron microscopy showed that the average diameter of CDots was about 12 nm. CCK-8 assay and apoptosis assay showed that CDots were biocompatible. Laser confocal microscopy results showed that CDots could be taken up by BMSCs. The results of alkaline phosphatase staining and alizarin red staining showed that CDots increased staining. mRNA expression of the osteogenic genes OPN, OCN, BMP-2, and autophagy-related genes LC3, Beclin1, ATG-12 was increased by CDots compared to the control group(P<0.05). In vitro antibacterial assays indicated that CDots could inhibit the growth of Porphyromonas gingivalis and Fusobacterium nucleatum. CONCLUSIONS: CDots prepared with gentamicin and folic acid are biocompatible, have dual osteogenic and antibacterial effects, promote osteogenic differentiation of BMSCs, promote elevated autophagy levels, and have inhibitory effects on the growth of Porphyromonas gingivalis and Fusobacterium nucleatum. Reference | Related Articles | Metrics

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Imaging evaluation and analysis of jaw invasion in mandibular gingival carcinoma based on micro-CT WANG Jian, ZHANG Ye, HOU Cheng-su China Journal of Oral and Maxillofacial Surgery    2023, 21 (1): 36-40.   DOI: 10.19438/j.cjoms.2023.01.006 Abstract （243）      PDF （937KB）（152）       Knowledge map    PURPOSE: To evaluate and analyze the imaging features of mandibular invasion, in order to provide imaging evidences for optimizing the operation plan and guiding postoperative treatment for gingival squamous cell carcinoma (GSCC). METHODS: Sixty patients underwent surgery for mandibular GSCC were included. Preoperative panoramic radiograph, ordinary CT and enhanced CT scanning were analyzed. Micro-CT three-dimensional reconstruction was performed on 30 eligible surgical specimens in order to measure bone mineral density, trabecular thickness, trabecular separation and other related parameters. SPSS 22.0 software package was used for data analysis. RESULTS: Conventional imaging examination with panoramic radiograph, CT and enhanced CT scaning were insufficient. Micro-CT three-dimensional reconstruction could accurately distinguish between cancellous bone and bone cortex, assess the scope and degree of mandibular invasion. The corresponding data parameter analysis indicated that bone mineral density (BMD) of the GSCC central and marginal area was significantly reduced comparing with the BMD at the normal mandibular bone area(P<0.05). In addition, the thickness of trabecular bone was also significantly reduced（P<0.05). The BMD of cancellous bone was significantly decreased(P<0.05). The separation degree of trabecular bone in cancer center was obviously increased comparing with the normal mandibular tissue(P<0.05). CONCLUSIONS: Currently, there are still controversies about the surgical plan for mandibular gingival cancer, and further improving the accuracy of CT examination may provide more accurate guidance for making surgical plan for mandibular gingival cancer. Reference | Related Articles | Metrics

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Effect of columnar collagen sponge on the extraction of impacted teeth and the risk of complications WANG Chen-xin, PENG Jing, HUANG Xin, SHI Le, DAI Xiao-feng China Journal of Oral and Maxillofacial Surgery    2023, 21 (2): 146-151.   DOI: 10.19438/j.cjoms.2023.02.008 Abstract （434）      PDF （963KB）（149）       Knowledge map    PURPOSE: To investigate the effect of collagen sponge in the extraction of impacted teeth and the risk of complications. METHODS: A total of 160 patients with impacted teeth extraction were selected from June 2021 to December 2021 in Shanghai Jing'an Dental Clinic. The patients were randomly divided into experimental group and control group, 80 cases in each group. Both groups underwent conventional extraction of impacted teeth, and the control group was rinsed with 20 mL sodium chloride solution after extraction. In the experimental group, on the basis of the control group, columnar collagen sponge was inserted into the extraction wound. Bleeding, postoperative pain score, postoperative swelling degree 7 days after surgery, levels of inflammatory factors[prostaglandin E2(PGE2), myeloperoxidase(MPO), calcitonin gene-related peptide(CGRP)] in gingival crevicular fluid before and after treatment and postoperative complications (restricted opening, inflammatory induration or bruising of maxillofacial region, infection, dry socket) were compared between the two groups. SPSS 22.0 software package was used for data analysis. RESULTS: The postoperative bleeding time of the experimental group was significantly lower than that of the control group(P<0.05). The VAS scores of spontaneous pain and dysphagia in the experimental group were significantly lower than those of the control group(P<0.05). The swelling degree of experimental group was significantly lower than that of control group 7 days after tooth extraction(P<0.05). There was no difference in PGE2, MPO and CGRP between the two groups before treatment(P>0.05). After treatment, PGE2, MPO and CGRP in the two groups were significantly increased(P<0.05), PGE2, MPO and CGRP of the experimental group after treatment were significantly lower than those of the control group after treatment(P<0.05). The incidence of postoperative complications in the experimental group was significantly lower than that in the control group (P<0.05). CONCLUSIONS: Columnar collagen sponge has a good effect in extraction of impacted teeth, and can effectively avoid postoperative complications, and has little influence on inflammatory factors in gingival crevicular fluid, which is worthy of wide application. Reference | Related Articles | Metrics

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Long-term performance of dental implants in vascularized iliac crest grafts for mandibular reconstruction in 14 consecutive patients GU Yu-wei, WANG Feng, HUANG Wei, ZHANG Zhi-yong, ZHANG Chen-ping, SUN Jian, WU Yi-qun China Journal of Oral and Maxillofacial Surgery    2022, 20 (5): 422-428.   DOI: 10.19438/j.cjoms.2022.05.002 Abstract （178）      PDF （2039KB）（148）       Knowledge map    PURPOSE: To evaluate the long-term performance of dental implants installed in vascularized iliac crest grafts for mandibular reconstruction by clinical and radiographic examinations. METHODS: From 1995 to 2005, 47 implants installed in vascularized iliac crest grafts for mandibular reconstruction in 14 patients were analyzed, including 30 implants immediately placed into vascularized iliac crest grafts in 10 patients and 17 implants placed later in 4 patients. The cumulative survival rate within 15 years of dental implants and prostheses was evaluated. Clinical assessments and radiographic examination were performed 5 years and 10 years after implant loading. Statistical analysis was performed using SPSS 26.0 software package. RESULTS: No early failures occurred during the healing period. Cumulative survival rates of implants for 10 years and 15 years were 90.44% and 86.67% and cumulative survival rate of prostheses for 15 years was 78.32%, respectively. The average marginal bone loss at 5 years was (2.08±0.27) mm, while that at 10 years was (4.22±0.48) mm (P<0.0001). Biological complications were peri-implantitis and soft tissue hyperplasia, and mechanical complication was abrasion of the prostheses mainly. CONCLUSIONS: The long-term performance of dental implants installed in vascularized iliac crest grafts for mandibular reconstruction is stable, which is an effective method for mandibular defect reconstruction, but the incidence of peri-implantitis is relatively higher. So, maintaining the stability of soft and hard tissues around the implant is a crucial guarantee for the long-term performance of implants. Reference | Related Articles | Metrics

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Single-cell transcription atlas for mandibular condyle cartilage and subchondral bone marrow in rat temporomandibular joint osteoarthritis YU Ye-ke, DING Ruo-yi, SUN Jia-li, ZHANG Zhi-yuan, HE Dong-mei China Journal of Oral and Maxillofacial Surgery    2023, 21 (4): 332-339.   DOI: 10.19438/j.cjoms.2023.04.003 Abstract （197）      PDF （2829KB）（146）       Knowledge map    PURPOSE: To establish the single-cell transcriptome atlas for rat condyle osteochondral tissue and bone marrow both in normal and temporomandibular joint osteoarthritis (TMJOA) condition. METHODS: Rat unilateral anterior crossbite(UAC) model was built to induce TMJOA. Osteochondral cells and bone marrow immune cells were extracted for single-cell RNA sequencing. Quality control, dimension reducing, clustering and marker gene detection were used to depict cell subclusters. Differential gene expression analysis and functional enrichment were utilized to demonstrate cell cluster functions and their changes under UAC. Pseudo-time analysis was applied for cell development trajectory, while cell communication prediction was used to show alternations in the interaction among cell clusters. RESULTS: There were 9 cell clusters in rat condyle, containing osteochondral cells and bone marrow immune cells. Under UAC, the number of osteochondrocytes decreased whereas immune cells accumulated. Condyle cartilage and bone tissue contained 6 functional groups of cells. Among them, D and F group maintained progenitor characteristics and possessed the ability to develop into other groups. In UAC condition, osteochondrocytes witnessed impaired extracellular matrix organization, activated senescent or inflammatory pathways, and diminished cell-cell interaction. Meanwhile, in the bone marrow, neutrophils showed enhanced chemotaxis and degranulation, mononuclear-phagocytes displayed increased phagosomes, activated B cells were also recruited. CONCLUSIONS: There are progenitor cells in condyle cartilage and bone tissue, whose function impaired under UAC. At the same time, immune cells in the bone marrow are activated. Targeted modulation of osteochondral progenitors and immune cells could contribute in alleviation the condyle tissue damage in TMJOA. Reference | Related Articles | Metrics

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Construction of home care program for patients with oromaxillofacial head and neck tumor undergoing tracheotomy based on Delphi method XU Zhu-feng, HOU Li-li, WANG Yue-ping, XIE Yu-ting, LIU Liu, YU Xi-xi China Journal of Oral and Maxillofacial Surgery    2022, 20 (4): 371-377.   DOI: 10.19438/j.cjoms.2022.04.010 Abstract （226）      PDF （912KB）（143）       Knowledge map    PURPOSE: To construct a home care program of tracheotomy for patients with oromaxillofacial head and neck tumor. METHODS: Based on content analysis of the literature, semi-structured?interviews and theoretical framework, the first draft of home care program for patients with oromaxillofacial head and neck tumor was constructed. Delphi method was used to carry out two rounds of mail inquiry to 15 experts in relevant fields to determine the final scheme. SPSS 25.0 software package was used for data analysis. RESULTS: The questionnaire return rate of the two rounds of expert consultation was 100% and the overall expert authority coefficient was 0.88. The coefficient of variation of importance was 0-0.16 and the coefficient of variation of feasibility was 0-0.17. The scheme included 4 primary indicators, 9 secondary indicators and 31 tertiary indicators. CONCLUSIONS: The home care program of tracheotomy for patients with oromaxillofacial head and neck tumor constructed in this study meets the needs of this group of patients. The construction of the program is scientific and feasible, also provides a reference for clinical practice. Reference | Related Articles | Metrics

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CT and MRI features of 29 patients with inflammatory myofibroblastic tumor in the head and neck WANG Can, ZHANG Chun-ye, TAO Xiao-feng, WANG Bo-cheng, ZHU Ling China Journal of Oral and Maxillofacial Surgery    2022, 20 (5): 494-499.   DOI: 10.19438/j.cjoms.2022.05.014 Abstract （231）      PDF （1266KB）（143）       Knowledge map    PURPOSE: To analyze the imaging features of inflammatory myofibroblastic tumor (IMT) in the head and neck through CT and MRI, and improve the correct diagnosis of the tumor before operation. METHODS: From January 2012 to December 2018, a total of 29 patients with IMT in the head and neck who were initially diagnosed and confirmed by postoperative pathology were retrospectively collected in Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine. Their preoperative CT and MRI findings were analyzed. RESULTS: Of the 29 patients with IMT in the head and neck, 67.0%(20/29) were misdiagnosed as malignant tumors before operation. The imaging findings of IMT in the head and neck were varied, 7 cases were identified as localized soft tissue mass, 12 cases with soft tissue mass and adjacent bone destruction (5 in the infratemporal fossa, 6 in the maxillary sinus, 1 in the wide maxillofacial region), and 10 cases with intraosseous mass (5 in the maxilla, 4 in the mandible, 1 in the temporal bone). 89.7%（26/29）were presented as uneven margins. 75.9%（22/29）showed bone destruction, 34.5%（10/29）with hyperostosis and remodeling. Eight cases had a peri-neural infiltration(6 cases occurred in the infratemporal fossa, with 4 cases suffered from invasion through foramen rotundum and foramen ovale, 2 cases invaded the optic canal, 2 cases occurred in the mandible and invaded the mandibular nerve canal). The IMT in the head and neck showed isodense or slightly hypodense, with no calcification on CT plain scan, and moderate/marked enhancement after contrast-enhanced scanning. MRI showed 9 cases with isointense or hypointense on T1 weighted images, 7 cases with hypointense on T2 weighted images, 9 cases with hyperintense on DWI. The range of ADC value of IMT (9 cases) was about (0.6-1.0)×10-3mm2/s. The TIC type of 7 cases was typeⅠ, and 2 cases with typeⅡ. There were no cervical lymph node metastasis and distant metastasis. CONCLUSIONS: IMT in the head and neck has certain imaging characteristics that are commonly found in malignant tumors. However, IMT in the head and neck can erode and remodel bone, with striped hypointense on T2 weighted image, mostly type I, few cervical lymph node metastasis and distant metastasis. CT, MRI and functional examination can reflect the tissue composition of the lesion to a certain extent, and provide an important basis for the correct preoperative diagnosis. Reference | Related Articles | Metrics