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10 November 2014, Volume 12 Issue 6 Previous Issue    Next Issue

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Basic Research Articles

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Establishment of a rabbit model for mandibular osteoradionecrosis ZONG Chun-lin1, GUO Yu-xuan1, DOU Gen2, ZHANG Yu2, TIAN Lei1, LIU Yan-pu1 2014, 12 (6):  481-486.  Abstract ( 359 )   HTML ( 1 )   PURPOSE : The present study was performed to establish a standard animal model of mandibular osteoradionecrosis (ORN) in rabbit and to evaluate the irradiated mandibles based on clinical manifestation, single-photon emission computed tomography (SPECT), micro-CT, and histological observation. METHODS : According to the biological equivalent formula and hypofractionation radiation method, twenty-four rabbits were randomly divided into 4 groups: group 1 served as control, the left mandibles in group 2, 3 and 4 received iron irradiation at doses of 8.0, 8.9 and 9.7Gy every two days and 5 times respectively using linear accelerator. Forty-five days after irradiation, the left mandibular molars were extracted in all groups. Three months later, the mandibles in all groups were examined by clinical manifestation, SPECT, micro-CT, and histological observation to select the most suitable model. The data was analyzed with SPSS17.0 software package. RESULTS : Two rabbits died in group 4 because of malnutrition. Alopecia of the irradiated skin, sequestration and bone exposure in irradiated mandibles, and fibrosis in medulla were found in Group 3 and 4. In group 2, alopecia was less significant, and the mandibles had mainly showed medullary infection. Group 3 and 4 showed decreased BV/TV, Tb.Th, Tb.N and increased Tb.Sp compared to group 1 and 2. SPECT showed that bone metabolic rate in group 3 and 4 decreased significantly. CONCLUSION : We successfully established a reproducible rabbit model with mandibular osteoradionecrosis using iron radiation at dosage of 8.9 Gy with postradiation dental extractions. This model can serve as a platform for future studies on pathogenesis and treatment of ORN. References | Related Articles | Metrics

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A new method for primary culture of salivary gland cells of rats in vitro WEI Yi, WANG Dai-you, CHENG Meng, SU Yue-song 2014, 12 (6):  487-491.  Abstract ( 435 )   HTML ( 5 )   PURPOSE : To establish the primary culture model of salivary gland epithelial cells from Wistar rats in vitro and provide seeds cells for studies of salivary diseases. METHODS : The parotid gland was obtained from Wistar rats which were 1-2 days old under sterile conditions, and the gland capsule was removed under the operating microscope. The parotid gland cells were cultivated with tissue block method in serum-free medium (kerotinocyte, SFM) containing rat epidermal growth factor (rEGF), bovine pituitary extract (BPE), hydrocortisone, transferrin, insulin, etc. The morphology of the culture cells was observed under inverted phase contrast microscope. The cells were identified by H-E staining and cytokeratin, vimentin immunohistostaining. RESULTS : The morphology of parotid gland epithelial cells was triangle, polygon, round or short spindle, and the cells displayed monolayer growth with loose connections. H-E staining showed the cells were round, with blue-stained nuclei, projections and intercellular bridge. The cells were positive for cytokeratin, which confirmed that the cultured cells were from epithelium origin. Most cells were positive for vimentin, actin and calponin, which further determined the cultured cells were mainly myoepithelial cells. The primary cells grew well in 3-5 days, and could survive for about one week. CONCLUSIONS : The parotid gland epithelial cells of Wistar rat are simply and quickly cultivated with tissue block method. The primary culture model of parotid gland epithelial cells in vitro was successfully established. References | Related Articles | Metrics

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Experimental study on the guided tissue regeneration membrane promoting bone formation in rabbit mandibular distraction osteogenesis TANG Xiao-peng, YUAN Kui-feng, LAI Qing-guo, YANG Zhong-jun, CI Jiang-bo 2014, 12 (6):  492-497.  Abstract ( 413 )   HTML ( 3 )   PURPOSE : To investigate the promotive effect of guided tissue regeneration membrane (GTRM) in rabbit mandibular distraction osteogenesis (DO). METHODS : Twenty New Zealand’s white rabbits were randomly divided into 2 groups with ten in each, and then mandibular distraction osteogenesis model in rabbits was established. In group A, only DO was performed on one side of the mandible; in group B, the distraction device was positioned and fixed on the mandible with GTRM inside wrapped around the distraction zone. Half of the animals randomly chosen from each group were sacrificed at the end of week 2 and 6 throughout the consolidation phase. The mandibular samples were taken out for X-ray and histologic examinations. The data was analyzed with SPSS 11.0 software package. RESULTS: Radiological and histological study confirmed that group B showed better bone formation than group A (P<0.05) at the end of 2nd and 6th week consolidation. CONCLUSION : GTRM could effectively promote bone regeneration in rabbit mandibular DO. References | Related Articles | Metrics

Clinical Articles

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Magnetic resonance image for diagnosis of perforation of the temporomandibular joint SHEN Pei, HUO Liang, ZHANG Shan-yong, YANG Chi, YUN Bai, CHEN Zhuo-zhi 2014, 12 (6):  498-502.  Abstract ( 918 )   HTML ( 16 )   PURPOSE : To evaluate the value of magnetic resonance image (MRI) on the diagnosis of perforation of the temporomandibular joint (TMJ). METHODS : Consecutive 1845 patients (2524 TMJs) diagnosed as temporomandibular disorders (TMD) were collected from April 1st, 2003 to March 1st, 2010 in our department. All the patients were examined by MRI and treated by arthroscopy or operation. The findings of interpreting MRI were recorded as positive, suspicious and negative according to the MRI radiographic criteria. After comparing the findings of MRI with those of arthroscopy or operation, the numbers of true positive, true negative, false positive and false negative were obtained. Through SPSS16.0 software package, receiver operator characteristic curve (ROC curve) was made with 1-specificity as abscissa and the sensitivity as ordinate, and the area under the ROC curve was calculated. According to the area, the diagnostic value of MRI was evaluated. RESULTS : According to the criteria above, we found 189 TMJs were positive, 197 TMJs were suspicious, and 2138 TMJs were negative. After comparing the findings of MRI with those of arthroscopy or operation, true positive in 102 TMJs and false positive in 87 TMJs were detected among 189 positive TMJs, perforation in 42 TMJs and no perforation in 155 TMJs were detected among 197 suspicious TMJs, and true negative in 2075 TMJs and false negative in 63 TMJs were detected among 2138 negative TMJs. The area under ROC curve was 0.808(0.77,0.85)(P<0.05). CONCLUSIONS : It is concluded that the diagnostic accuracy of MRI was good, but the accuracy depends on both whether there was joint fluid and the experience of the doctors. References | Related Articles | Metrics

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Application and effect evaluation of rapid prototyping technology and plaster model surgery in orthognathic treatment of mandibular asymmetry WU Ye1, HUANG Yue2, XIE Fu-ping1, NIU Gang1, HUANG Li2, LIN Li-song1, 2 2014, 12 (6):  503-508.  Abstract ( 391 )   HTML ( 0 )   PURPOSE : Rapid prototyping (RP) technology was employed to make high quality 3-dimensional head simulator, which was then precisely combined with a fine plaster cast of dental arch by facebow for model surgery to guide orthognathic surgery for mandibular asymmetry and evaluate the effect. METHODS : Fifteen patients with dento-maxillofacial deformities underwent spiral CT scan to collect raw data, which was inputted into rapid prototyping machine to generate 3-dimensional head-simulators. The plaster casts of dental arch were subsequently replaced with those of 3-dimensional head-simulators in the same ratio. Finally, RP-plaster cast complexes were formed for simulating osteotomy prior to surgery, in order to assess the position and volume of osteotomy, the symmetry of chin and variation of temporomandibular joint (TMJ), and surgical effect 6 months after operation. RESULTS : RP-plaster cast complexes from 15 patients were shown to be good for predicting the effect of surgery. Two cases were still found to have mental deviation and chin plasty was carried out after bilateral mandibular sagittal split osteotomy (BSSRO). The 6-month follow-up results showed the patients were satisfied with their appearance and had no complications including TMJ disorder. CONCLUSIONS : RP-plaster cast complex is valuable in precisely simulating osteotomy, contributing to understanding postoperative alteration of chin and TMJ and assessing surgical effect and possible complications. References | Related Articles | Metrics

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Clinical investigation of the idiopathic condyle resorption XIONG Wei, SU Kai, ZHENG You-hua, HE Yi-qing, KUANG Shi-jun, ZHANG Zhi-guang 2014, 12 (6):  509-514.  Abstract ( 1130 )   HTML ( 17 )   PURPOSE : To summarize the clinical and imaging characteristics of idiopathic condylar resorption (ICR) and investigate the pathogenic factors and susceptible factors of ICR. METHODS : Forty-six ICR patients were included who were treated between 2007 and 2012. The clinical data was collected. The facial type, condition of TMJ and occlusion were recorded. On X-ray films, the ramus height, destruction of condyle, craniofacial features were evaluated. Correlation between condylar resorption and the position relationship between the disc and the condyle were assessed by arthrography with Cone-beam CT (CBCT). RESULTS : Idiopathic condylar resorption often occurred in females (42 cases, 91.30%) and teenagers. The patients had a common facial morphology including skeletal and occlusal high-angle Class II deformity, anterior open bite, high occlusal plane angle and mandibular plane angle, progressively retruding mandible. The patients always had TMJ symptoms, such as joint sound. X-ray film showed extreme thinness or loss of continuity of cortical bone on the head of the condyle and vertical height of the ramus decreased. TMJ disc perforation could be observed by arthrography with CBCT. The position of perforation was always on the posterior of disc. CONCLUSIONS : ICR has its own unique pathogenesis and clinical features. There is correlation between TMJ disc displacement and ICR, Disc displacement may reinforce and promote ICR, and vice versa. References | Related Articles | Metrics

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Classification and measurement of alveolar bone thickness of deeply impacted mandibular third molar GE Jing, YANG Chi, FAN Lin-feng, HE Dong-mei 2014, 12 (6):  515-520.  Abstract ( 649 )   HTML ( 5 )   PURPOSE : The aim of the present study was to measure the alveolar bone thickness of the deeply impacted mandibular third molar, and classify the molar based on the proximity to the external cortical bone. METHODS : Cone-beam CT(CBCT) data from 110 deeply impacted mandibular third molars were measured. At the center of crown, cenmeto-enamel junction and root, the distance between the tooth and the external bone surface was measured for both buccal and lingual side. The samples were classified into 3 groups (buccal, central and lingual position) by the following 3 methods: the first method was distance comparison: if the average difference of buccal-lingual alveolar bone thickness was less than 1 mm, the tooth was classified as central position,otherwise, the tooth was classified as buccal or lingual position. The second method was visual observation on CBCT images. The third method was to compare the relationship of third molar and dentition. Take distance comparison as gold standard to evaluate the sensitivity and specificity of the latter two methods. RESULTS : The samples were classified by distance comparison as: 1 buccal position (0.9%), 13 central position (11.8%), and 96 lingual position (87.3%). The samples were classified by visual observation as: 1 buccal position (0.9%), 16 central position (14.5%), and 93 lingual position (84.5%). The samples were classified by dentition relationship as: 59 buccal position (53.6%), 48 central position (43.6%), and 3 lingual position (2.7%). The sensitivity of visual observation for lingual, central and buccal position was 91.67%, 61.54% and 100%, respectively,the specificity was 64.29%, 91.75% and 100%, respectively,the youden index was 0.56, 0.53 and 1, respectively. The sensitivity of dentition relationship classification for lingual, central and buccal position was 3.13%, 0% and 100%, respectively,the specificity was 100%, 50.52% and 46.79%, respectively,the youden index was 0.03, 0.49 and 0.53, respectively. CONCLUSIONS : Among deeply impacted mandibular third molars, lingual position ranks the first, central position ranks the second and buccal position ranks the third. Visual observation is reliable for lingually or buccally displaced molar. Dentition relationship classification is not related to alveolar bone thickness. References | Related Articles | Metrics

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Anatomic analysis of the infrazygomatic crest width WU Jun, CHEN Zhen-qi 2014, 12 (6):  521-524.  Abstract ( 1595 )   HTML ( 29 )   PURPOSE : Using dental 3D-CT to analyse the infrazygomatic crest width. METHODS : In 21 orthodontic patients, infrazygomatic crest width was measured and analyzed in 41 CT images of the maxillary first molar root. SPSS16.0 software package was used for statistical analysis. The infrazygomatic crest width and first molar root length were compared in gender, left and right side, in mesial and distal buccal root side, to determine of there was a significant difference. RESULTS : The anatomical structure of infrazygomatic crest was bone structure with great variation. Individual difference existed in the thickness of infrazygomatic crest. There was no significant difference between sex and right and left side. As the measurement moved cranially, infrazygomatic crest width decreased gradually. Significant difference existed in first molar root length between male and female, the root length was significantly longer in male than in female. CONCLUSIONS : Individual differences existed in the width of infrazygomatic crest. Measurement and analysis of the infrazygomatic crest width is needed in this region before inserting orthodontic miniscrews. References | Related Articles | Metrics

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The case-control study of affecting factors leading to peri-implantitis CAO Yu-jie1, SHI Bin1, CHEN Jiang2, XIE Qin3 2014, 12 (6):  525-529.  Abstract ( 424 )   HTML ( 3 )   PURPOSE : The relevant factors leading to peri-implantitis are discussed so as to provide evidence for clinical prevention and control. METHODS : A case-control study was conducted. The cases were divided into 2 groups. Group A consisted of 52 cases with confirmed peri-implantitis after dental implantation and prosthesis in our hospital from January 2010 to June 2013; Group B consisted of 95 cases without peri-implantitis after dental implantation and prosthesis at the same time. Logistic regression analysis was conducted to analyze the patients’ own factors and doctors’ surgical performance which were closely related to peri-implantitis with SPSS16.0 software package. RESULTS : Variables significant in single factor analysis were age, diploma, periodontosis, smoking, diabetes, regular teeth cleaning, special care products after implantation and prosthesis pattern of upper structure (P<0.05). Multifactor retrospective analysis suggested that smoking, diabetes, periodontosis, site of implantation were risk factors leading to peri-implantitis while regular teeth cleaning was a protective factor. CONCLUSIONS : Patients’ own factors are main risk factors for peri-implantitis. Therefore we suggest that operation candidates should be strictly selected; hygiene education for high risk patients should be strengthened; follow up visits after operation are necessary in order to detect and treat peri-implantitis in time if it should occur. References | Related Articles | Metrics

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Analysis of prognostic factors in lower gingival squamous cell carcinoma YANG Hong1, 2, SONG Xiao-meng1, CHEN Jie1, YANG Xue-ming1, CHU Wei-ming1, WU Yu-nong1 2014, 12 (6):  530-534.  Abstract ( 701 )   HTML ( 9 )   PURPOSE : To analyze the factors of affecting prognosis by using retrospective study of 68 cases of squamous cell carcinoma (SCC) of the mandibular gingiva. METHODS : A retrospective study of 68 cases of SCC in the mandibular gingiva were carried out, all cases were from Department of Oral and Maxillofacial Surgery, School of Stomatology, Nanjing Medical University from 2003 to 2012. Kaplan-Meier survival analysis was used to evaluate 3- and 5-year overall survival rate (OSR), factors of affecting prognosis were analyzed by using univariate Log-rank and multivariate Cox regression survival analysis with SPSS 20.0 software package. RESULTS : Sixty-eight patients were included in the study, the 3- and 5-year OSR were 77.2% and 72.3%. Univariate Log-rank analysis showed that tumor location in the buccal or lingual side, cervical lymph node metastasis and recurrence were significantly related to survival rate (P<0.05). Multivariate Cox regression analysis showed that tumor location in the buccal or lingual side, lymph node metastasis and local recurrence were independent prognostic factors of OSR (P<0.05). CONCLUSIONS : In SCC of the mandibular gingiva, tumor location in the buccal or lingual side, cervical lymph node metastasis and recurrence were significantly related to survival rate and were independent prognostic factors of OSR. References | Related Articles | Metrics

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Efficacy and safety of minimally invasive internal fixation of zygomatic fractures DING Fan 2014, 12 (6):  535-538.  Abstract ( 255 )   HTML ( 1 )   PURPOSE : To investigate the efficacy and safety of minimally invasive internal fixation of zygomatic fractures. METHODS : Seventy-one cases of zygomatic fractures in our hospital from June 2005 to June 2013 were randomly divided into experimental and control groups. The experimental group underwent open reduction and internal micro-titanium fixation via oral route, while the control group had micro-titanium plate fixation under direct vision via the coronal incision. The nasal, temporal movement on the injured side after 3 months, the mouth opening and the degree of enophthalmos in the 2 groups before and after surgery were compared. The clinical efficacy and incidence of postoperative complications in 2 groups of patients after 6 months were compared. The data was statistically analyzed using SPSS 18.0 software package. RESULTS : The degree of temporal and nasal movement at the injured side 3 months after surgery were significantly lower than those before surgery (P<0.01). The degree of temporal and nasal movement at the injured side 3 months after surgery in the experimental group were significantly lower than control group (P<0.01). The degree of enophthalmos 3 months after surgery was significantly greater than before surgery, while the degree of retraction was significantly less than that before surgery (P<0.01). The degree of mouth opening in the experimental group 3 months after surgery was significantly greater than that in the control group, the degree of enophthalmos was significantly less than the control group (P<0.01). The clinical efficacy of the experimental group was significantly higher than the control group 6 months after surgery (P<0.05). Incidence of postoperative complications in the experimental group was significantly lower than the control group (P<0.05). CONCLUSIONS : Minimally invasive internal fixation of the zygomatic fractures via oral route has minor trauma, good clinical efficacy and lower postoperative complication rate, which is worthy of clinical application. References | Related Articles | Metrics

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Adverse effects of timolol maleate 0.5% solution combined with propranolol in treating infantile hemangiomas WANG Jia, SHI Jing, WANG Xu-kai 2014, 12 (6):  539-542.  Abstract ( 651 )   HTML ( 4 )   PURPOSE : To observe the adverse effects of using topical timolol maleate 0.5% solution in combination with oral propranolol and oral propranolol alone for infantile hemangiomas (IH). METHODS : A total of 60 infants with IH were included in this study, in which 30 patients were treated with topical timolol maleate 0.5% solution combined with oral propranolol and the remaining 30 cases received oral propranolol alone. All patients showed no abnormalities on physical examination before the treatment. The changes of heart rate and blood pressure were monitored before and 1h after treatment. Potential side effects such as vomiting, lethargy, diarrhea, local skin reactions, cold extremities, and hypoglycemia were observed and recorded 1-month after treatment. The data was statistically analyzed with SPSS13.0 software package. RESULTS : There was no significant difference in adverse effects between the 2 groups and the difference was not significant in heart rate and blood pressure before and 1 h after treatment. CONCLUSIONS : The adverse reactions were similar between patients receiving topical timolol maleate 0.5% solution in combination with oral propranolol and oral propranolol alone, no serious adverse events were found. References | Related Articles | Metrics

Clinical Reports

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Alveolar soft part sarcoma of the oral and maxillofacial region: clinical analysis of 18 patients WANG Hong-wei, QIN Xing-jun, YANG Wen-jun, XU Li-qun, JI Tong, ZHANG Chen-ping 2014, 12 (6):  543-548.  Abstract ( 317 )   HTML ( 2 )   PURPOSE : To summarize the clinical features, diagnosis, treatment strategies and prognosis of alveolar soft part sarcoma (ASPS) of oral and maxillofacial region. METHODS : We performed a retrospective study in a consecutive series of 18 patients with ASPS in the oral and maxillofacial region between 1995 and 2013. Demographics, tumor sizes, sites, metastasis and diagnosis of disease, treatments provided, and follow-up outcomes were documented and analyzed. RESULTS : Eighteen patients (10 females, 8 males mean age of 20.2 years, range, 3-61 years) who were diagnosed pathologically had their primary tumor in the tongue (10), cheek (5), pharynx (1), gingival (2), with an average size of 4 cm (range, 1.5-6.5 cm). Two patients exhibited pulmonary metastases. Extensive resections were performed in all patients. Postoperative radiotherapy was delivered in 3 cases, and adjuvant systemic chemotherapy was given to 1 case. Mean follow-up periods were 33 months (range, 6-75 months). At the latest follow-up, one patient with lung metastases survived for 19 months, and one died 3 months after confirmation of local recurrence and multiple pulmonary metastases, the other patients remained in good health and were disease-free. CONCLUSIONS : ASPS of the oral and maxillofacial region has unique clinical characteristics. The immunohistochemical findings and PAS-positive results help to make the final diagnosis. The most commonly advocated and effective treatment for ASPS of oral and maxillofacial region remains to be radical surgical excision of the lesions. References | Related Articles | Metrics

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Reduction and fixation of tetrapod zygomatic fractures with a stable medial end of fracture segment YANG Li-juan1, LIU Chun-ming2, DUAN Hai-nan1, WANG Kai1, LIU Wei-dong, ZHANG Zhan-le1, LI Mei-fang1 2014, 12 (6):  549-553.  Abstract ( 840 )   HTML ( 4 )   PURPOSE : Zygomatic fractures usually need reduction and fixation of all the fracture segments through coronal, subciliary, or transconjunctival, and intraoral approach. The purpose of this paper was to explore a technique of fracture management without subciliary and intraoral approach and fixation for certain type of tetrapod zygomatic fracture. METHODS : In cases of type B zygomatic fractures by Zingg classification, with a stable maxillary structure inward and an inconspicuously displaced medial end of fracture segment, half-coronal approach was used. Sequential reduction and fixation was performed in zygomatic arch posterior-anteriorly. Alignment of fracture segments at the site of fronto-zygomatic suture was checked, and then synthesis was done. There was no need for subciliary, intraoral approach and fixation at infraorbital edge and zygomaticomaxillary buttresses. RESULTS : Reduction and fixationn of fractures was accomplished successfully in a series of 6 patients, postoperative CT scan showed anatomical reduction of the bone segments and firm fixation in all patients. Facial width and zygomatic prominence recovered symmetry and facial configuration restored satisfactorily. Mouth opening was normal. No injury was found in temporomandibular joint, eyes and facial nerves. CONCLUSIONS : Anatomical reduction and firm fixation of the bone segments could be achieved by this simplified management in certain type of tripod zygomatic fractures with a stable maxillary structure inward and an inconspicuously displaced medial end of fracture segment. References | Related Articles | Metrics

Review Article

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Three-dimensional finite element analysis of the mandible CAO Li-fei, SHEN Tie-bing 2014, 12 (6):  554-557.  Abstract ( 433 )   HTML ( 6 )   Mandible is the only mobile bone in the lower third of the face, which is the largest, the most wide and prominent in the maxillofacial region. Moreover, it is easily affected by various of forces. Clarifying the stress distribution and transmission after loading is very important and attracting more and more attentions from both clinicians and researchers. In this paper, the mandible was analyzed by three-dimensional finite element modeling, with regard to the biomechanical properties, stress distribution which can provide a reference for clinical research. References | Related Articles | Metrics

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Progress of treatments of odontogenic maxillary sinusitis HU Ying-kai, XU Guang-zhou, YANG Chi 2014, 12 (6):  558-564.  Abstract ( 769 )   HTML ( 26 )   Odontogenic maxillary sinusitis (OMS) is a common disease that requires surgery as well as treatments of the odontogenic source. Surgical treatments include apectomy and closure of oro-antral fistula, classic or modified Caldwell-Luc operation and endoscopic surgery. This article reviewed the progress of surgical treatments of OMS and provided some help for clinical work. References | Related Articles | Metrics

Case Reports

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Clinical and radiologic finding of arthroscopic surgery for synovial chondromatosis of the temporomandibular joints: affiliatedcase report ZHU Yao-min, ZHENG Cang-shang, DENG Yong-qiang, LIANG Zhi-gang 2014, 12 (6):  565-568.  Abstract ( 472 )   HTML ( 4 )   Synovial chondromatosis (SC) is a benign, chronic, and progressive arthropathy with the presence of multiple loose bodies which requires surgical removal. Its main characteristic is the formation of cartilaginous nodules that may be pedunculated and/or detach from the synovial membrane, becoming loose bodies within the joint space. More recently, arthroscopic surgery of the TMJ has increased in popularity because it is less invasive than open surgery, is associated with few complications, and requires a shorter hospital stay. It allows surgeons to diagnose and treat intra-articular conditions directly with a minimally invasive technique. We presented a new case of unilateral SC of the TMJ, including diagnostic images, treatment performed and histological analysis, arthroscopy was used to remove 112 loose bodies completely. References | Related Articles | Metrics

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Inter-dental distraction osteogenesis before bone grafting for alveolar cleft: one case report TANG Yan-mei, TAO Li, NIE Ping, ZHANG Jian-fei, SHEN Guo-fang, ZHU Min 2014, 12 (6):  569-572.  Abstract ( 452 )   HTML ( 4 )   In patients with alveolar cleft, when both sides of the cleft are overlapped, dislocated or vertically displaced, it is hard for surgeons to achieve success in bone grafting. Inter-dental distraction osteogenesis is effective in narrowing wider alveolar cleft with new bone as well as obtaining soft tissues. It provides a brand new way assisting alveolar cleft treatment. As regard to the design, individual device is recommended for each patient according to the real complexity of the clefts. Apart from the distraction direction, surgeons should also consider the efficiency of the force and the comfort of the distractor. References | Related Articles | Metrics

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Osteomyelitis of the mandible associated with malignant infantile osteopetrosis:a case report and literature review WANG Jie-qi, ZHANG Da-ming, ZHENG Mei-hua, CHEN Wei-liang 2014, 12 (6):  573-576.  Abstract ( 325 )   HTML ( 2 )   Osteopetrosis is a rare congenital genetic disease characterized by increased bone density due to impaired bone resorption by osteoclasts. The incidence of autosomal recessive osteopetrosis, also called malignant infantile osteopetrosis, is 1:300000. This article presented a typical case of osteomyelitis of the mandible associated with malignant infantile osteopetrosis, and reviewed the relevant literature on the pathogenesis, clinical manifestations, radiological feature and treatment of osteopetrosis. References | Related Articles | Metrics