China Journal of Oral and Maxillofacial Surgery

Effect of condylar bone marrow-derived mesenchymal stem cells on chondrogenic differentiation in young rats induced by nasal obstruction

WANG Xiao-ling, SUN Hui-jun, ZHU Yan-fei, TANG Yan-mei, XUE Xiao-chen, NIE Ping, ZHU Min

2017, 15 (1): 1-5. doi: 10.19438/j.cjoms.2017.01.001

Abstract ( 317 )

PURPOSE: This study was designed to utilize the animal model of nasal obstruction to investigate its effect on chondrogenic differentiation of condylar bone marrow-derived mesenchymal stem cells (BMSCs). METHODS: Forty 4-week-old SD rats were randomly divided into the bilateral nasal obstruction group (28 rats) and the control group (12 rats). The animal experiment lasted for 4 weeks, from 8:00 to 16:00 every day. During modeling, bilateral condylar BMSCs were cultured in vitro, CCK-8 was used to compare the difference of cell proliferation,real-time polymerase chain reaction (RT-PCR) was used to detect the difference of gene expression of BMSCs chondrogenic marker genes (Agg, COL-Ⅱ, SOX -9). The data were statistically analyzed using SPSS19.0 software package. RESULTS: There was no significant difference of condylar BMSCs proliferation ability between the two groups (P>0.05), but the expression of chondrogenic marker genes were all significantly lower in the experimental group (P<0.05). CONCLUSIONS: It is suggested that the mechanism of mandibular deficiency caused by long-term mouth breathing is closely related to the inhibition of condylar BMSCs to cartilage differentiation.

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Macroporous calcium phosphate cement, human embryonic stem cells and platelet-rich plasma constructs for bone regeneration in cranial defects in rats

WU Zhen-zhen, BAO Chong-yun, LI Ming-zheng, LIU Xian

2017, 15 (1): 6-10. doi: 10.19438/j.cjoms.2017.01.002

Abstract ( 338 )

PURPOSE: To investigate the effects of macroporous calcium phosphate cement (CPC), human embryonic stem cells (hESC) and platelet-rich plasma constructs for bone regeneration in vivo in critical-sized cranial defects in rats. METHODS: Three groups were tested in rats: (a) CPC with hESC-derived mesenchymal stem cells (CPC+hESC-MSCs); (b) CPC with hESC-MSCs and 30% platelet rich plasma (PRP) (CPC+hESC-MSCs+30%PRP) and (c) CPC+hESC-MSCs+50%PRP. 18 rats were sacrificed 12 weeks after operation. Micro-CT and bone histomorphologic analysis were conducted to compare the status of new bone formation. SPSS16.0 software package was used for one way analysis of variance. RESULTS: At 12 weeks in vivo, the groups with hESC-MSCs and PRP had more new bone formation compared with other two groups; however, there was no significant difference in new bone area fraction between different concentration of PRP groups. CONCLUSIONS: Macroporous CPC with hESC-MSCs and PRP may be useful for bone regeneration in craniofacial and orthopedic fields.

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Review of the international course on vascular anomalies: concepts and controversies held in Berlin, 2016

LI Kai, YAO Wei

2017, 15 (1): 10-10.

Abstract ( 201 )

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Characteristics of the anatomical structures observed on cone beam CT images in the mandibular interforminal region

QU Zhe, HU Yan-jun, MA Lan, ZHANG Xiang, HAN Wen-li, LI Zhen-chun

2017, 15 (1): 11-15. doi: 10.19438/j.cjoms.2017.01.003

Abstract ( 807 )

PURPOSE: This study was aimed to analyze the anatomical structures in the mandibular interforminal region by cone-beam CT (CBCT), and provide recommendations to the surgeon about a new safe surgical margin in this region. METHODS: A total of 104 CBCT radiographs were obtained, the mental canal, mandibular incisive canal, mandibular lingual foramen and its bony canal were measured on CBCT. The mean value and standard deviations were calculated. The data were analyzed with SPSS19.0 software package. RESULTS: The mental canal was visible in 55.29% of the scans, and the mean length was 1.12 mm.The lingual foramen and its canal were visible in 94.23% of the scans, and the mean length was 1.77 mm. The distances from the incisive canal to buccal plate were smaller than to lingual plate. CONCLUSIONS: In the absence of CBCT scans, the new relative safe margins should be a distance of at least 6 mm between the anterior border of the mental foramen and the most distal interforaminal implant fixture or bone harvest site; the maximum bone harvest depth is suggested to be 3 mm and implants length should be less than 14 mm in the placement of the anterior mandible implant.

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Analysis of magnetic resonance imaging of 171 patients with synovial chondromatosis in the temporomandibular joint

HAN Zi-xiang, CHEN Min-jie, YANG Chi, WEI Wen-bin, SHI Hui-min

2017, 15 (1): 16-19. doi: 10.19438/j.cjoms.2017.01.004

Abstract ( 456 )

PURPOSE: To evaluate the classification and potential aggressive behavior of temporomandibular joint (TMJ) synovial chondromatosis(SC) on magnetic resonance imaging by analyzing its MRI characteristics. METHODS: MRI data of 171 patients who suffered from synovial chondromatosis of TMJ treated in our hospital during April 2004 to December 2015 were collected. On the basis of MRI findings, there were three categories: type of loose body, type of homogeneous mass and type of mixture of both loose body and homogeneous mass. The MRI findings of bony erosion included 4 stages: without erosion, chondral destruction, bony absorption and bony perforation. The relationship between categories and bony erosion and the differences between bony erosion on MRI and surgical findings were analyzed. Chi-square test or Fisher's exact test was performed using SAS 16.2 software package. RESULTS: Type of loose body include 55 cases (32.16%), type of homogeneous mass include 84 cases (49.12%) and type of mixture include 32 cases (18.71%). According to surgical findings, 70 cases (40.94%) had bony erosion; however, MRI could not distinguish the stage of chondral destruction. Among 14 cases with bony perforation, 11 (78.57%) belonged to the type of homogeneous mass, 3 (21.43%) belonged to the type of mixture; compared to the stage without erosion, there was significant difference (P=0.009). Among all patients, 2 had recurrence. CONCLUSIONS: Synovial chondromatosis with the type of homogeneous mass and type of mixture on MRI were more aggressive. Patients with these types needs synovium removal, even partial osteotomy.

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Effect of total joint TMJ prosthesis in the treatment of temporomandibular joint ankylosis

HE Dong-mei, HU Yi-hui, YANG Chi, CHEN Min-jie, ZHANG Shan-yong, LI Hui, BAI Guo, ZHANG Lu-zhu, LU Chuan, HUANG Dong

2017, 15 (1): 20-25. doi: 10.19438/j.cjoms.2017.01.005

Abstract ( 482 )

PURPOSE: The aim of the study was to apply and evaluate the effect of total TMJ prosthesis in the treatment of temporomandibular joint(TMJ) ankylosis. METHODS: Patients treated from 2013 to 2015 were reviewed. Computer-aided design and manufacture (CAD/CAM) technique was used to guide bony mass removal and locate the TMJ prosthesis (Biomet, USA). Free fat harvested from the mandibular incision subcutaneously was grafted around the artificial condylar head to prevent ectopic bone formation. For cases with severe mandibular deficiency, the mandibular ramus was elongated by the prosthesis and combined with Le Fort I osteotomy under the guide of digital occlusal splint. At least 1 year follow-up was completed after operation to evaluate mouth opening, occlusal stability, bone resorption around screws and ectopic bone formation around artifical condylar head. RESULTS: Eleven patients with 15 joints were included. In 4 patients with severe mandibular deficiencies, their mandibular ramus was elongated by TMJ prostheses combined with Le Fort I osteotomy guided by digital templates. There was no prosthesis loosening, breakage, or infection leading to removal during a mean follow-up period of 22.9 months (12-31 months) after operation. Mouth opening was significantly improved from 5.5 mm preoperatively to 31.5 mm postoperatively (P<0.05). No ectopic bone formation was found around the artificial condyles, and no bone resorption was detected around the screws on CT scans. CONCLUSIONS: TMJ prosthesis is a reliable treatment option for ankylosis, especially in recurrent cases. It can correct jaw bone deformities simultaneously with stable results.

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Selection of endoscopic approach to tumors located in pterygopalatine fossa and infratemporal fossa

SHI Zhao-hui, QIAO Li, CHEN Xiao-dong, LI Xiao-yuan, CHEN Fu-quan

2017, 15 (1): 26-30. doi: 10.19438/j.cjoms.2017.01.006

Abstract ( 467 )

PURPOSE: To describe different endoscopic approaches to remove tumors located in the pterygopalatine fossa (PPF) and infratemporal fossa (ITF) and to analyze the indications and outcomes of these surgical techniques in management of tumors localized in these areas. METHODS: Fifty patients with benign and malignant tumors arising in or extending to the PPF and ITF, treated from 2010 to 2014 at Xijing Hospital, Fourth Military Medical University were retrospectively reviewed. Before surgery, the patients underwent CT and MRI examination. According to tumor type and extent of invasion, three kinds of surgical plan and endoscopic approach were designed. The patients were followed up after surgery and the outcomes were assessed. RESULTS: Fifty consecutive patients were included, among them 31 had benign tumors (24 juvenile nasopharyngeal angiofibromas, 5 extracranial trigeminal schwannomas, 2 chordomas), 8 cases of cyst (5 odontogenic cysts, 3 epidermoid or dermoid cysts); 11 had malignant tumors (5 adenoid-cystic carcinomas, 2 malignant ameloblastomas, 2 chondrosarcomas, 1 neurofibrosarcoma and 1 malignant schwannoma). Three kinds of endoscopic approach were applied, including endoscopic endonasal approach in 27 cases, transmaxillary approach in 9 cases and combined endonasal and transmaxillary approach in 14 cases. Postoperatively, 8 patients with malignant tumors received adjuvant treatment. The mean follow-up was 34.3 months (from 6 to 55 months). Three patients were lost to follow-up, two patients with malignant tumor had recurrence, one patient with neurofibrosarcoma had metastasis. All patients with benign tumor and cyst had no recurrence. CONCLUSIONS: Tumors of PPF and ITF are not infrequent. According to tumors type, biological behaviors, we can select different appropriate endoscopic approaches to resect the tumors and reduce injuries and the incidences of complications at the same time.

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Evaluation of condyle remodeling after costochondral graft in growing children with temporomandibular joint ankylosis and jaw deformity

ZHAO Jie-yun, HE Dong-mei, YANG Chi, LU Chuan, HU Yi-hui

2017, 15 (1): 31-35. doi: 10.19438/j.cjoms.2017.01.007

Abstract ( 402 )

PURPOSE: To evaluate the long-term result after costochondral graft (CCG) in growing children with temporomandibular joint (TMJ) ankylosis and jaw deformity. METHODS: Patients from 2010 to 2014 with unilateral TMJ ankylosis and jaw deformity treated by CCG were evaluated. Their CT data within 1 week after operation and during at least 1 year follow-up were measured by ProPlan CMF 1.4 software. Condyle-ramus, chin deviation and the length of CCG were measured and compared after operation and during follow-ups. SPSS 17.0 software was used for statistical analysis. RESULTS: Six patients with a mean age of 5 years old (from 3 to 7 years old) were included in the study. The mean follow-up period was 2.7 years. The mean condyle-ramus elongation by CCG was 6.2 mm and chin deviation correction was 5.3 mm after operation. The mean growth of CCG was 6.9 mm. The mean mandibular ramus growth was 4.4mm in the healthy side and 4.3 mm in the affected side (P>0.05). CONCLUSIONS:CCG is a reliable method to treat TMJ ankylosis with jaw bone deformity in growing children. It has growing ability but the long-term results still need observation.

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Characteristics of the anatomical structures observed on cone beam CT images in the mandibular interforminal region

QU Zhe, HU Yan-jun, MA Lan, ZHANG Xiang, HAN Wen-li, LI Zhen-chun

2017, 15 (1): 36-40. doi: 10.19438/j.cjoms.2017.01.008

Abstract ( 467 )

] PURPOSE:This study was aimed to analyze the anatomical structures in the mandibular interforminal region by cone-beam CT (CBCT), and provide recommendations to the surgeon about a new safe surgical margin in this region. METHODS: A total of 104 CBCT radiographs were obtained, the mental canal, mandibular incisive canal, mandibular lingual foramen and its bony canal were measured on CBCT. The mean value and standard deviations were calculated. The data were analyzed with SPSS19.0 software package. RESULTS: The mental canal was visible in 55.29% of the scans, and the mean length was 1.12 mm.The lingual foramen and its canal were visible in 94.23% of the scans, and the mean length was 1.77 mm. The distances from the incisive canal to buccal plate were smaller than to lingual plate. CONCLUSIONS: In the absence of CBCT scans, the new relative safe margins should be a distance of at least 6 mm between the anterior border of the mental foramen and the most distal interforaminal implant fixture or bone harvest site; the maximum bone harvest depth is suggested to be 3 mm and implants length should be less than 14 mm in the placement of the anterior mandible implant.

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Analysis of magnetic resonance imaging of 171 patients with synovial chondromatosis in the temporomandibular joint

HAN Zi-xiang, CHEN Min-jie, YANG Chi, WEI Wen-bin, SHI Hui-min

2017, 15 (1): 41-45. doi: 10.19438/j.cjoms.2017.01.009

Abstract ( 435 )

PURPOSE: To evaluate the classification and potential aggressive behavior of temporomandibular joint (TMJ) synovial chondromatosis(SC) on magnetic resonance imaging by analyzing its MRI characteristics. METHODS: MRI data of 171 patients who suffered from synovial chondromatosis of TMJ treated in our hospital during April 2004 to December 2015 were collected. On the basis of MRI findings, there were three categories: type of loose body, type of homogeneous mass and type of mixture of both loose body and homogeneous mass. The MRI findings of bony erosion included 4 stages: without erosion, chondral destruction, bony absorption and bony perforation. The relationship between categories and bony erosion and the differences between bony erosion on MRI and surgical findings were analyzed. Chi-square test or Fisher's exact test was performed using SAS 16.2 software package. RESULTS: Type of loose body include 55 cases (32.16%), type of homogeneous mass include 84 cases (49.12%) and type of mixture include 32 cases (18.71%). According to surgical findings, 70 cases (40.94%) had bony erosion; however, MRI could not distinguish the stage of chondral destruction. Among 14 cases with bony perforation, 11 (78.57%) belonged to the type of homogeneous mass, 3 (21.43%) belonged to the type of mixture; compared to the stage without erosion, there was significant difference (P=0.009). Among all patients, 2 had recurrence. CONCLUSIONS: Synovial chondromatosis with the type of homogeneous mass and type of mixture on MRI were more aggressive. Patients with these types needs synovium removal, even partial osteotomy.

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Analysis of magnetic resonance imaging of 171 patients with synovial chondromatosis in the temporomandibular joint

HAN Zi-xiang, CHEN Min-jie, YANG Chi, WEI Wen-bin, SHI Hui-min

2017, 15 (1): 46-50. doi: 10.19438/j.cjoms.2017.01.010

Abstract ( 392 )

PURPOSE: To evaluate the classification and potential aggressive behavior of temporomandibular joint (TMJ) synovial chondromatosis(SC) on magnetic resonance imaging by analyzing its MRI characteristics. METHODS: MRI data of 171 patients who suffered from synovial chondromatosis of TMJ treated in our hospital during April 2004 to December 2015 were collected. On the basis of MRI findings, there were three categories: type of loose body, type of homogeneous mass and type of mixture of both loose body and homogeneous mass. The MRI findings of bony erosion included 4 stages: without erosion, chondral destruction, bony absorption and bony perforation. The relationship between categories and bony erosion and the differences between bony erosion on MRI and surgical findings were analyzed. Chi-square test or Fisher's exact test was performed using SAS 16.2 software package. RESULTS: Type of loose body include 55 cases (32.16%), type of homogeneous mass include 84 cases (49.12%) and type of mixture include 32 cases (18.71%). According to surgical findings, 70 cases (40.94%) had bony erosion; however, MRI could not distinguish the stage of chondral destruction. Among 14 cases with bony perforation, 11 (78.57%) belonged to the type of homogeneous mass, 3 (21.43%) belonged to the type of mixture; compared to the stage without erosion, there was significant difference (P=0.009). Among all patients, 2 had recurrence. CONCLUSIONS: Synovial chondromatosis with the type of homogeneous mass and type of mixture on MRI were more aggressive. Patients with these types needs synovium removal, even partial osteotomy.

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Selection of endoscopic approach to tumors located in pterygopalatine fossa and infratemporal fossa

SHI Zhao-hui, QIAO Li, CHEN Xiao-dong, LI Xiao-yuan, CHEN Fu-quan

2017, 15 (1): 51-55. doi: 10.19438/j.cjoms.2017.01.011

Abstract ( 626 )

PURPOSE: To describe different endoscopic approaches to remove tumors located in the pterygopalatine fossa (PPF) and infratemporal fossa (ITF) and to analyze the indications and outcomes of these surgical techniques in management of tumors localized in these areas. METHODS: Fifty patients with benign and malignant tumors arising in or extending to the PPF and ITF, treated from 2010 to 2014 at Xijing Hospital, Fourth Military Medical University were retrospectively reviewed. Before surgery, the patients underwent CT and MRI examination. According to tumor type and extent of invasion, three kinds of surgical plan and endoscopic approach were designed. The patients were followed up after surgery and the outcomes were assessed. RESULTS: Fifty consecutive patients were included, among them 31 had benign tumors (24 juvenile nasopharyngeal angiofibromas, 5 extracranial trigeminal schwannomas, 2 chordomas), 8 cases of cyst (5 odontogenic cysts, 3 epidermoid or dermoid cysts); 11 had malignant tumors (5 adenoid-cystic carcinomas, 2 malignant ameloblastomas, 2 chondrosarcomas, 1 neurofibrosarcoma and 1 malignant schwannoma). Three kinds of endoscopic approach were applied, including endoscopic endonasal approach in 27 cases, transmaxillary approach in 9 cases and combined endonasal and transmaxillary approach in 14 cases. Postoperatively, 8 patients with malignant tumors received adjuvant treatment. The mean follow-up was 34.3 months (from 6 to 55 months). Three patients were lost to follow-up, two patients with malignant tumor had recurrence, one patient with neurofibrosarcoma had metastasis. All patients with benign tumor and cyst had no recurrence. CONCLUSIONS: Tumors of PPF and ITF are not infrequent. According to tumors type, biological behaviors, we can select different appropriate endoscopic approaches to resect the tumors and reduce injuries and the incidences of complications at the same time.

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Correlation between the pattern of zygomaticomaxillary complex fracture and infraorbital nerve injury: a clinical study in 70 patients

SU Jia-nan, XU Xiao-feng, XU-Bing

2017, 15 (1): 56-58. doi: 10.19438/j.cjoms.2017.01.012

Abstract ( 610 )

PURPOSE: To investigate the association between infraorbital nerve sensory disturbances and zygomaticomaxillary complex (ZMC) fracture patterns. METHODS: Seventy patients with isolated unilateral ZMC fractures were examined on both uninjured and affected sides by using pain threshold test and two-points discrimination test. The fractures were classified according to classic Zingg's classification. Injury of the infraorbital nerve was expressed as asymmetry index (AI). SPSS19.0 software package was used for statistical analysis. RESULTS: The results suggested that neurosensory disturbance was present in all 70 patients with ZMC fracture. In the test of pain threshold, infraorbital nerve injury severity was different among different fracture patterns (P<0.05). Two-points discrimination test showed that infraorbital nerve injury was more severe in type B and C than in type A (P<0.05), but the difference between B and C was not significant. CONCLUSIONS: Infraorbital nerve injury is a common complication of ZMC fracture, type B fracture has the highest grade of nerve damage, while type A fracture has the lowest grade of nerve damage.

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Comparison of forearm flap and anterolateral thigh flap in reconstruction of oral and maxillofacial defects

ZHANG Jie, MENG Jian, ZHUANG Qian-wei, WU Rui-han, WANG Xing

2017, 15 (1): 59-62. doi: 10.19438/j.cjoms.2017.01.013

Abstract ( 477 )

PURPOSE: To compare and analyze the clinical effectiveness of forearm flap and anterolateral thigh flap in reconstruction of oral and maxillofacial defects. METHODS: Fifty-four cases undergoing oral and maxillofacial defect reconstruction with forearm flap and anterolateral thigh flap were reviewed. Thirty-three cases used forearm flap (group A), and 21 cases used anterolateral thigh flap after tumor resection. Operative duration, survival rate of flap, shape changes of recipient site, donor site and patients' satisfaction were analyzed between 2 groups with SPSS 19.0 software package. RESULTS: The operative duration of group A was （41.6±8.9） min, （47.2±10.2） min in group B, and the difference was statistically significant (P<0.05). Flap survival rate was 93.9% in group A and 90.5% in group B, the difference was not statistically significant (P>0.05). Shape changes of recipient site in group A were similar to group B. Donor site recovery was better in group B. The rate of permanent dysfunction in group A was 24.2% and 0 in group B, and the rate of temporal dysfunction was 9.5% in group B. CONCLUSIONS: Forearm flap was as useful as anterolateral thigh flap in reconstruction of postoperative defects of oral and maxillofacial tumors. In clinical practice, advantages and disadvantages should be considered according to individual conditions in selection of free flaps.

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Preliminary study of the short-time remolding of upper airway after uvulopalatopharyngoplasty

YAO Kan, WANG Meng, YU Wen-wen, XU Lei, WEI Si-long, SUN Hong-xia, LU Xiao-feng

2017, 15 (1): 63-68. doi: 10.19438/j.cjoms.2017.01.014

Abstract ( 410 )

PURPOSE: To explore the remolding of upper airway in patients with obstructive sleep apnea-hyponea syndrome (OSAHS) after uvulopalatopharyngoplasty (UPPP). METHODS: Twenty-one male adult patients aged 27 to 52 years were included and followed up from pre-operation to 6 months after operation. Lateral cephalometric radiographs (conventional and when pronouncing "i" ) were taken before operation and 3 days, 1, 2, 3, 6 months after operation. The anterolateral diameters of different level of upper airway and parameters of hyoid position at each time point were measured by AUTOCAD 2015. SAS 8.02 software package was used to analyze the difference. RESULTS: UPPP mainly affected the velopharyngeal and glossopharyngeal areas: parameters wane (P<0.05). On the other hand, UPPP led to the decline and retrusion of hyoid. The nasopharynx kept statical (P>0.05) while the velopharyngeal parameters were increased (P<0.05) with reducing velocities (P<0.05). The glossopharyngeal parameters increased in the first month after UPPP (P<0.05), while hypopharyngeal parameters underwent decline since 2 months after UPPP (P<0.05). The hyoid underwent decline and retrusion (P<0.05) , while endured a short-time increase in the first month after UPPP (P<0.05). CONCLUSIONS: Short-time upper airway remolding after UPPP does exist.

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Clinical effect of flapless immediate tooth implantation for maxillary anterior teeth

LUO Rong, LUO Jun, HUANG Cai-hong

2017, 15 (1): 69-72. doi: 10.19438/j.cjoms.2017.01.015

Abstract ( 443 )

PURPOSE: To evaluate the effect of flapless immediate tooth implantation for maxillary anterior teeth. METHODS: Eighty-eight patients treated from September 2014 to August 2015 in our hospital were collected. They were randomly divided into experimental group and control group, 44 cases in each group. Patients in the control group underwent traditional immediate tooth implantation, while patients in the experimental group underwent flapless immediate tooth implantation. The operation time, the survival rate of the implant, alveolar bone health, satisfaction, aesthetics, and postoperative symptoms in 2 groups were recorded and compared. SPSS 11.5 software package was used for data analysis. RESULTS: The operation time in the experimental group was significantly shorter than the control group, which was (29.34±2.42)min vs (55.32±3.54) min; alveolar bone in the experimental group was significantly superior to the control group(P<0.05), which was (0.84 ±0.04) mm vs (1.21±0.07) mm; the survival rate of the experimental group was significantly higher than the control group(P<0.05), which was 93.18% (41/44) vs 72.73% (32/44). After treatment, VAS score and PES score in the experimental group were significantly higher than the control group, which was (8.32±0.42) vs (5.78±0.24), (11.24±0.43) vs (8.45±0.58), respectively(P<0.05). The incidence of postoperative pain, redness and swelling, bleeding in the experimental group was significantly lower than control group, which was 18.18% (8/44) vs 38.64% (17/44), 15.91% (7/44) vs 34.09% (15/44) and 11.36% (5/44) vs 29.55% (13/44), respectively(P<0.05). CONCLUSIONS: Flapless dental implantation can improve the satisfaction of patients with dental implants, aesthetic, and success rate of implantation, reduce operation time, pain, and incidence of postoperative pain, redness and other symptoms.

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Percutaneous sclerotherapy of arteriovenous malformations of the maxillofacial soft tissues using fibrin glue combined with OK-432 and bleomycin following embolization in 13 consecutive patients

QIN Ze-man, HUANG Zhi-quan, CHEN Wei-liang, ZHAO Xiao-peng, CHEN Rui

2017, 15 (1): 73-76. doi: 10.19438/j.cjoms.2017.01.016

Abstract ( 358 )

PURPOSE: To evaluate the clinical curative effect of percutaneous sclerotherapy of arteriovenous malformations (AVMs) of soft tissues of the maxillofacial region using fibrin glue combined with OK-432 and bleomycin. METHODS: Thirteen patients with AVMs of the maxillofacial region (8 males and 5 females; mean age: 28.2 years, range: 16-46 years) were treated with a percutaneous injection of fibrin glue combined with OK-432 and bleomycin for 3-5 times following super-selective intra-arterial embolization (SIAE). RESULTS: All patients had significant swelling postoperatively for up to 1 week without major complications. The follow-up period ranged from 14-58 months (mean: 27.4 months). Three lesions were completely involuted, eight lesions were mostly involuted, and other two lesions were partially involuted. None of the lesions showed minimal involution or non-involution. CONCLUSIONS: Percutaneous sclerotherapy using fibrin glue combined with OK-432 and bleomycin following SIAE provides a simple, safe, and reliable alternative treatment for AVMs of soft tissues of maxillofacial region.

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Study of the treatment strategy of cerebral infarction caused by blunt internal carotid artery injuries resulting from maxillofacial trauma: a report of 8 cases

CHENG Zhi-hua, OUYANG Huo-niu, LUO Cong, GUO Yu, GUO Zhi-lin

2017, 15 (1): 77-79. doi: 10.19438/j.cjoms.2017.01.017

Abstract ( 420 )

PURPOSE: To estimate the treatment strategies of cerebral infarction with severe maxillofacial trauma resulting in blunt internal carotid artery injuries (BCAIs). METHODS: The clinical data of 8 patients with cerebral infarction caused by BCAIs were retrospectively analyzed between January 2008 and December 2013. RESULTS: Of 8 patients, 6 were male and 2 were female, aged 19-54 years (mean 36±11.95 years). The time from injury to admission was 5-8 hours (mean 6.31±1.00 hours). All patients were awake after injury and presented with neurologic ischemia at admission, 6 cases with drowsiness, 2 cases with semicoma (1 case developed coma one day later) and 6 cases with hemiparalysis. Eight cases with facial fractures were diagnosed by CT scans, and 2 cases with skull base fractures, 1 case with mandible fracture. The ischemic lesions involved in internal carotid artery supply area and no intracranial hemorrhage was identified following head and neck CT scans. All 8 patients received aspirin 300 mg/d for 2 weeks and 100 mg for the following 6 months, and 1 case underwent craniotomy. For GOS scores 6 month after injury, 6 cases had good recovery, 1 case was with moderate disability, 1 case was with severe disability and no case died. CONCLUSIONS: The patients with blunt internal carotid artery injuries complicated by maxillofacial fractures should be diagnosed in early stage, and the application of antiplatelet therapy could reduce BCAIs stroke-related morbidity and mortality.

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Development of international dentoalveolar surgery

HU Kai-jin, WANG Jing-juan, XUE Yang

2017, 15 (1): 80-85. doi: 10.19438/j.cjoms.2017.01.018

Abstract ( 524 )

Dentoalveolar surgery, formerly known as oral surgery or dental surgery, is not only one of the basic branches but also a common clinical speciality of oral and maxillofacial surgery. This paper reviewed the development of dentoalveolar surgery worldwide in the following aspects, including exodontias, periapical surgery, tooth transplantation, tooth re-implantation, and pre-prosthodontics surgery, in order to provide reference for the readers.

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