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10 March 2014, Volume 12 Issue 2 Previous Issue    Next Issue

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Editorial

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Craniomaxillofacial bone frame reconstruction for patients with obstructive sleep apnea-hypopnea syndrome LU Xiao-feng 2014, 12 (2):  99-106.  Abstract ( 491 )   Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a common disease. Craniomaxillofacial bone hypoplasia, obese, mass in the upper airway, dysfunction of upper airway dilator muscles and central respiratory disorders may result in the diseases. Surgical treatment is the main and effective method for management of OSAHS, which includes two manners: craniomaxillofacial bone frame reconstruction and reduction of soft tissue around upper airway. The former can achieve stable results by craniomaxillar bone expand or advancement, but may lead to profile change and more trauma; while the later provides more spaces by means of resection of soft tissues around the upper airway, such as tongue and soft palate, etc, which means some function will be impaired or lost. References | Related Articles | Metrics

Basic Research Articles

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Biomechanical analysis of mandibular body defect reconstruction with fibula fixed with miniplates YIN Xue-min, LIU Xiong, FU Sheng, ZHANG Jun-wei, XU Guo-xiang 2014, 12 (2):  107-111.  Abstract ( 355 )   PURPOSE: To investigate the stress distribution characteristics and displacement of mandibular body defect reconstruction with fibula fixed with miniplates and to provide mechanical reference for clinical practice. METHODS: Finite element model of mandibular body defect reconstruction with fibula fixed with miniplates was established and contralateral molar and incisor vertical loading was simulated. Then stress of plates, screws and displacement of anterior and posterior ends of the fibula were analysed. RESULTS: Stress of corresponding miniplates, screws and displacement values of anterior and posterior fibula in incisor loading condition were larger than that of in molar loading condition. Maximum displacement value of anterior fibula in incisor loading condition was 264.22 microns, while 149.02 microns in molar loading conditions. Maximum stress values of all miniplates occurred in the posterior plate. Maximum stress of screws in the mandibular stumps occurred in the anterior superior screw near the mandible /fibula adjunction. Stress of screws began to decrease along the direction of nail tip, but stress in the one third tip of screw increased. CONCLUSIONS: It is very important to choose bicortical screw when mandibular body defect reconstruction with fibula in fixations. Biting on front teeth before bone healing to reduce the risk of nonunion should be avoided. References | Related Articles | Metrics

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Effect of RNA interference of TEAD gene on the proliferation and invasion of Tca8113 cell line XU Xian-yin, LIU Yang, YU Jun 2014, 12 (2):  112-115.  Abstract ( 240 )   PURPOSE: To investigate the effect of TEAD gene on biological behavior of tongue squamous cell carcinoma by endogenous TEAD gene knockdown using RNA interference technique in the tongue carcinoma cell line Tca8113. METHODS: Specific iRNA of TEAD gene was established and transfected into the cell line Tca8113. The TEAD gene expression in Tca8113 was detected after transfection using RT-PCR. Cell proliferation and migration were observed by CCK8 and Transwell methods, respectively. The experimental data was statistically analyzed by One-Way ANOVA with SPSS13.0 software package. RESULTS: After siRNA interference, Tca8113 cell line showed significantly decreased expression of TEAD gene (P<0.05), lower rate of proliferation (P<0.05), and weakened invasion (P<0.05) in vitro. CONCLUSIONS: The inhibition of TEAD gene expression by RNAi can suppress the growth, proliferation and migration of Tca8113 cell line, indicating a pivot role of TEAD gene in the pathogenesis of tongue squamous cell carcinoma. References | Related Articles | Metrics

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The biological effect of orthodontic tooth moving into alveolar cleft bone grafting area SUN Jian, CHEN Zhen-qi 2014, 12 (2):  120-124.  Abstract ( 388 )   PURPOSE: To study the biological effects of orthodontic tooth movement into alveolar cleft bone graft area, and evaluate expression of Trap/Rankl/Runx2 by real-time PCR. METHODS: The model of orthodontic tooth movement into alveolar cleft bone graft area was established in 8-week-old SD rats. The animals were sacrificed before orthodontic treatment and 1, 3, 5 days after orthodontic treatment. Bone formation was evaluated by H-E staining and the expression of Trap/Rankl/Runx2 was detected by Real-time PCR. SPSS 13.0 software package was used for two sample paired t test. RESULTS: The expression of Trap increased at early and middle stage, Rankl increased at early stage and Runx2 increased at late stage. CONCLUSIONS: Orthodontic tooth movement into alveolar cleft bone graft area promoted bone remodeling of embedded bone, induced osteoclastic process and subsequent osteogenesis. References | Related Articles | Metrics

Clinical Articles

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PUMA expression and its clinical significance in tongue squamous cell carcinoma LIU Bin, JIANG Fang-fang, YU Dong-sheng, LIU Zi-feng, ZHAO Wei 2014, 12 (2):  121-125.  Abstract ( 356 )   PURPOSE: To investigate the expression of PUMA (p53 up-regulated modulator of apoptosis) in tongue squamous cell carcinoma (TSCC), tongue tissues adjacent to cancer and normal tongue tissues, and to explore its clinical significance. METHODS: The expression of PUMA in resected samples from TSCC, tongue tissues adjacent to cancer and normal tongue tissues were detected by immunohistochemistry. The relationships between the expression of PUMA and the TNM staging, cell differentiation, and lymph node metastasis were analysed respectively. SPSS 17.0 software package was used for statistical analysis. RESULTS: Immunohistochemical studies demonstrated that PUMA expression was lower in TSCC (36.67%) than in tongue tissues adjacent to cancer(53.85%) and normal tongue tissues(80.00%). There was significant difference of PUMA expression in lymph node metastasis and lymph node without metastasis(P<0.05). The expression of PUMA in TSCC had no relation with age, gender, clinical stages, and the degree of cell differentiation(P>0.05). CONCLUSIONS: The results indicated that PUMA expression in TSCC is correlated with the pathogenesis and development of TSCC and lymph node metastasis and maybe a new promising target for treatment of TSCC. References | Related Articles | Metrics

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Adenoid cystic carcinoma of salivary gland: a clinicopathological study of 474 consecutive cases ZHANG Chun-ye, DENG Xu-xia, TIAN Zhen, WANG Li-zhen, HU Yu-hua, LI Lei, LI Jiang 2014, 12 (2):  126-130.  Abstract ( 890 )   PURPOSE: To investigate the clinicopathological features of salivary adenoid cystic carcinoma (ACC) in 474 Chinese patients. METHODS: The clinical and pathological characteristics of 474 primary salivary ACC diagnosed in Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were analyzed. SPSS18.0 software package was used for statistical analysis. RESULTS: Of the 474 ACC cases, the male-to-female ratio was 1.03:1 (240 to 234); the mean age was 52 years (from 11 to 83); the parotid and the palate were the most common locations of major and minor salivary gland respectively; the mean clinical course was 21 months (from 1 month to 37 years); 64% (301/474) patients had clinical symptom; 72%(343/474) patients were TNM stage Ⅱ and Ⅲ; 76%(360/474) patients had cribriform and tubular histological subtype. Tumor with solid pattern was associated with higher cervical lymph node metastasis (P=0.016). CONCLUSIONS: In Chinese population, ACC is more common in elder people and frequently involves the parotid gland and the palate. Most patients have clinical symptoms and histologically, cribriform and tubular types are more common. Patients with solid pattern have higher possibility to develop cervical lymph node metastasis than those with cribriform and tubular patterns. References | Related Articles | Metrics

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Classification of the impacted mandibular third molar using the mandibular canal as a reference and its clinical significance XU Guang-zhou, YANG Chi, FAN Xin-dong, YU Chuang-qi, WANG Yong, ZHANG Ying 2014, 12 (2):  131-135.  Abstract ( 647 )   PURPOSE: The purpose of this study was to access the position of third mandibular molar in relationship to the inferior alveolar nerve(IAN) injury during surgical extraction. METHODS: Six hundred and fifty-eight cases were diagnosed with impacted mandibular third molars(ITIMs) which were intersected with the inferior alveolar canal(IAC) by cone beam computed tomography(CBCT), they were classified using the IAC as a reference, the relationship of tooth root and IAC was divided into four types: ① The root was located above the IAC (type 1); ②The root was located on the buccal side (type 2); ③The root was located on the lingual side (type 3); ④ IAC was located between the roots (type 4). In all cases, the teeth were surgically extracted, and postoperative observations were performed to determine the category which was more likely to cause IAN damage. The data was analyzed with SPSS13.0 sofeware package for chi-square test. RESULTS: The overall rate of neurosensory impairment following extraction was 6.8%(45/658). It occurred in 15 patients whose root was located above the IAC (15/332), in 19 patients whose root was located on the buccal side of the IAC (19/108), and in 11 patients whose root was located on the lingual side (11/210). No neurosensory impairment was found in the group where the IAC was located between the roots (0/8). Statistical analysis showed there was significant difference between type 1 and type 2, and type 2 and type 3 (χ2 test, P<0.01); and there was no significant difference between the first group and the third group (χ2 test, P>0.05). CONCLUSIONS: The relationship between the IMTM and the IAC was divided into four categories using the IAC as a reference. Risk of IAN damage exists for patients during surgical extractions of IMTM that are intersected with the IAC, especially for those with impacted teeth that are located on the buccal side of the IAC. References | Related Articles | Metrics

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Personalized reconstruction of orbital defect based on the precise three-dimension orientation and measurement of eye socket HUANG Li, LIN Li-song, WANG Zhi-hong, SHI Bin, ZHU Xiao-feng, QIU Yu, HUANG Yue, YU Xue-yuan, LIAO Yun-yang 2014, 12 (2):  136-143.  Abstract ( 263 )   PURPOSE: To evaluated the methods for precise assessment of severity of traumatic orbital defect and techniques for customized reconstruction of orbital defect. METHODS: A retrospective study was conducted on 97 patients with traumatic orbital defect treated in our hospital from Jul. 2003 to Jun. 2012. Pre- and postoperative spiral computed tomography scans were available in all cases. Surgeons adapted a spatial location technique to measure the 3-dimensional position of the eyeball, followed by calculating the variation of orbital volume. Then the orbital model was fabricated utilizing computer-assisted design/manufacture and rapid prototyping technique to aid surgical planning and prefabricate implants and bone bonding plates. During surgery, surgeons fully exposed the orbital defect, then repositioned the herniated orbital contents and placed the prefabricated titanium mesh, Medpor or other implants to restore orbital morphology in the defect site and regain normal proportion between orbital walls and contents. The treatment outcome was evaluated in terms of postoperative appearance, patients’ satisfaction, ophthalmologic examination and CT scans and untoward complications were analyzed postoperatively. RESULTS: Except unsatisfactory aesthetic result in 1 case, residual enophthalmos and diplopia with no significant improvement 6 months after surgery in 2 cases resulting from long-standing trauma, mild postoperative lower eyelid ectropion in 2 cases, the remaining patients were satisfactory with the results both in orbital morphology and proportion between orbital walls and contents with no overt complications. CONCLUSIONS: With the advantage of accurate digital evaluation on 3-dimensional position of the eyeballs and variation of orbital volume and customized modeling surgery, surgeons are capable of simulating surgery and carrying out early operation to minimize trauma and maintain or correct the position of eyeballs as well as reconstruct orbital defect anatomically so that customized reconstruction of orbital defect is achieved and efficacy thereof is guaranteed. References | Related Articles | Metrics

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A clinical study of anterior alveolar bone reconstruction achieved through autogenous block bone in combination with guided bone regeneration(GBR) technique ZHENG Ji-si, ZHANG Shan-yong, YANG Chi, ZHANG Ying, ZHAO Jing-yong, YU Fei 2014, 12 (2):  144-151.  Abstract ( 271 )   PURPOSE: To evaluate and compare the differences of bone resorption between implant placement sites (IPS) and non-implant placement sites(NIPS) after anterior alveolar bone reconstruction achieved through autogenous block bone in combination with guided bone regeneration(GBR) technique. METHODS: From Dec. 2010 to Aug. 2011, a consecutive series of 14 patients (73 edentulous sites) with anterior alveolar bone atrophy were treated with autogenous block bone grafts in combination with GBR technique and delayed implant placement 6 months after augmentation. CT scans were performed preoperatively(T0), immediately after augmentation(T1), 3 months after augmentation (T2), 6 months after augmentation before implant placement (T3), 9 months after augmentation (T4), and the longest postoperative follow-up point (mean. 13.8 months) (T5). Alveolar crestal bone height (ACBW), alveolar midway bone width (AMBW), and alveolar bone height (ABH) were selected as measurement parameters in Simplant 11.04 software. All results were divided into two groups: implant placement sites (IPS) and non-implant placement sites (NIPS), and compared by the paired t test using SAS 9.0 software package. RESULTS: All block bone grafts and implant placement surgeries were completed successfully. Dizziness, headache and other uncomfortable conditions didn't occur and the incisions healed excellently. All implants remained clinically osseointegrated at the longest postoperative follow-up point. The bone remodelling of both groups for these three parameters were as follows: a) there were significant differences for the bone augmentation and resorption of ACBW and AMBW at T1 and T2 (P<0.05) and ABH at T1, T2 and T3 (P<0.05) in IPS; b) there were significant differences for the bone augmentation and resorption of ACBW and ABH at T1, T2, T3 and T4 (P<0.05) and AMBW at T1, T2 and T3 (P<0.05) in NIPS; c) there were no significant differences at other time periods for these three parameters of both groups (P>0.05). CONCLUSIONS: A more rapid and initial loss of alveolar bone in NIPS resulted from the mucoperiosteal flap reflection during implant placement surgery, while a less bone loss of alveolar happened in IPS due to implant placement. This reminded us of the importance of bone grafts in combination with immediate or early implant placement. References | Related Articles | Metrics

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Stable, dynamic, elastic miniplate osteosynthesis in cranio-maxillofacial surgery: evolution of concepts, biomechanical study and applications Maxime Champy, Astrid Wilk 2014, 12 (2):  152-166.  Abstract ( 270 )   An osteosynthesis of the mandible should be called stable when this type of treatment does not need to be supported by intermaxillary fixation, without disturbing the healing process. In that intention, many techniques of osteosynthesis based on different concepts were proposed during the last century. A classification of these concepts was formulated. The adaptive osteosynthesis which is pragmatically i.e. empirical, wherein the goal is immobilizing the fracture by bringing the fragments together and fixing them with rigid screwed plates. The rigid compressive osteosynthesis which is an extrapolation of the ideas of Lane proposed in 1912. The stable dynamic elastic osteosynthesis whose principles, equipment and technique as their applications were developed exclusively through biomechanical studies. The basic principle was the recovery of mobility by neutralization of detrimental distraction stresses, and reestablishment of favorable compressive stresses providing dynamic physiological stimulations. The biomechanical characteristics of the plates and the screws made possible the use of the fixation of all types of fractures or orthognathic procedures in mandibular surgery. With the application of mini or microplates in other facial bones and the skull, the art of fracture treatment and of reconstructive surgery of the craniomaxillofacial skeleton, including orthognathic and reconstructive surgery with or without bone grafting, has profoundly changed. At the present time, metal plates are sometimes superseded by resorbable plates and screws. Nevertheless, the fundamental biomechanical principles of osteosynthesis and bone healing remain unchanged. References | Related Articles | Metrics

Clinical Reports

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CT and MR imaging features of peripheral keratocystic odontogenic tumors ZHU Ling, ZHENG Jia-wei, YANG Jie 2014, 12 (2):  167-171.  Abstract ( 386 )   PURPOSE: Peripheral keratocystic odontogenic tumor (PKCOT) is a rare entity and the imaging findings have not been reported. The aim of this study was to explore CT and MR imaging characteristics of two PKCOTs in lateral facial deep region (LFDR), and review their clinical and radiological characteristics. METHODS: Nineteen PKCOTs were found, including seventeen from the literatures and two new cases reported in the present study. Sixteen of them were located in the gingiva, one in the buccal space and two in LFDR. CT imaging features were based on one PKCOT in the buccal space and two in LFDR. MR imaging features were detected on one PKCOT in LFDR, and conventional radiographic characteristics were determined on nine PKCOTs. RESULTS: The patients aged from 37 to 83 years, with a mean age of 56.5 years. The male to female ratio was 1:1.285, with no predilection for either gender. Buccal space(5.2%) and LFDR (10.5%) were relatively rare original sites for PKCOTs, compared with gingiva (84.2%). PKCOTs were clearly depicted on CT and MR imaging as they had cystic changes. Contents of the cysts were further analyzed by using different series of MRI. No radiological features were found on radiographs except one with minimal bone resorption in the alveolar crest. CONCLUSIONS: LFDR is a rare original site for PKCOT. PKCOT should be included as one of differential diagnosis of cystic lesions found in LFDR on CT and MR imaging. References | Related Articles | Metrics

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Surgical treatment of mandibular condylar neck fracture with submandibular small incision approach ZHOU Dong-sheng 2014, 12 (2):  172-174.  Abstract ( 326 )   PURPOSE: To evaluate the efficacy of submandibular small incision for treatment of condylar neck fracture. METHODS: The study included 26 cases with preoperative diagnosis of condylar neck fractures who needed surgical therapy. A small incision was performed in the mandibular angle, followed by separation and protection of the marginal mandibular branch of facial nerve, the posterior 1/3 of the masseter muscles were incised. After exposure of the fractures, anatomical reduction and titanium plate fixation were conducted. RESULTS: All patients returned to normal occlusion, and mouth opening was normal. There was no facial nerve injury among all patients. CONCLUSIONS: Good results were gained with submandibular approach using the space between marginal mandibular branch and inferior buccal branch of the facial nerve in patients suffering from condylar neck fractures. References | Related Articles | Metrics

Review Article

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Research progress of vascular endothelial growth factor in progression and prognosis of oral squamous cell carcinoma MA Hai-long, ZHONG Lai-ping, ZHANG Zhi-yuan 2014, 12 (2):  175-178.  Abstract ( 379 )   Vascular endothelial growth factor (VEGF) has proven to be the most critical angiogenic factor identified to dates, whose family members are composed of 7 ligands, 3 receptors and 2 co-receptors. Through multiple signaling pathways, VEGF shows capacities of promoting vascular endothelial cell proliferation and angiogenesis, lymphatic endothelial cell growth and lymphatic metastasis, and antiapoptotic cell biology effect. Tumor growth, metastasis and prognosis are closely related with VEGF. Newly-born vessels provide nutrition for tumor growth, as well as providing channel for tumor migration. This review focused on the molecular structure of VEGF and its receptors, signal mechanisms, cytology effects, and its relation with progression and prognosis of oral squamous cell carcinoma (OSCC ). References | Related Articles | Metrics

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Research progress in stability of dental arch after maxillary expansion in patients with unilateral complete cleft lip and palate YANG Li-an, CHEN Zhen-qi 2014, 12 (2):  179-183.  Abstract ( 327 )   During the growth spurt of cleft lip and palate patients, there is always three-dimensional maxillary hypoplasia. Constrictive maxillary arch is the typical characteristics, especially in complete cleft lip and palate patients. Therefore maxillary expansion becomes an important procedure of orthodontic treatment to cleft lip and palate patients, which can be classified into several types by the needs. This paper discussed the impact on the stability of dental arch from the standpoints of expansion method, age, arch form, and so on. References | Related Articles | Metrics

Case Reports

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Diffuse tenosynovial giant cell tumor of the infratemporal fossa and skull base: a case report and review of literature JIN Long, YANG Hong-yu, YANG Hui-jun, SHEN Shi-yue, WANG Feng, XIE Shu-le, ZHANG Shan-shan 2014, 12 (2):  184-188.  Abstract ( 457 )   Diffuse tenosynovial giant cell tumor is a kind of benign,local invasion venereal change of the joint synovial,articular capsule and tendon sheath,which rarely occurred in the infratemporal fossa and skull base.This paper reported a case of diffuse tenosynovial giant cell tumor located in the infratemporal fossa and skull base.Clinical presentation,radiological features,histopathological findings and treatment were discussed with review of the literature. References | Related Articles | Metrics

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Minimally invasive orthodontic-assisted extraction of mesioangular impacted lower third molar: a case report SHEN Yu-qing, MA Zhi-gui, ZHANG Ying, YANG Chi 2014, 12 (2):  189-192.  Abstract ( 329 )   Extraction of impacted lower third molar is a common procedure. Damage to the inferior alveolar nerve (IAN) is one of the severe complications, in that the roots of the tooth are often close to the nerve canal when it is impacted at a low position. For mesioangular impacted lower third molar, the adjacent second molar is likely to be injured accidentally during extraction. A case of mesioangular impacted lower third molar with its roots close to the inferior alveolar nerve canal treated with minimally invasive orthodontic assisted extraction was reported in this paper. The purpose of the orthodontic treatment was to upright the third molar to simplify the procedure of extraction, and to reduce postoperative complications. References | Related Articles | Metrics