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20 November 2017, Volume 15 Issue 6 Previous Issue    Next Issue

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Establishment and validation of patient-derived xenograft model of oral mucosal melanoma TAO Wen-jie, HAN Yong, ZHOU Rong, SHI Chao-ji, HONG Duo, LI Jiang, SUN Shu-yang, ZHANG Zhi-yuan 2017, 15 (6):  481-487.  doi: 10.19438/j.cjoms.2017.06.001 Abstract ( 317 )   PDF (6149KB) ( 335 )   PURPOSE: To establish and validate patient-derived xenograft (PDX) model of oral mucosal melanoma (OMM). METHODS: Four primary OMM specimens were implanted into immune-deficient nude mice subcutaneously, the mice were evaluated for tumor growth, stable xenograft tumor models and were passaged. Histopathological characteristics were observed by H-E staining. OMM-associated clinical markers (HMB-45, Melan-A, S-100 and Ki-67) were detected by immunohistochemistrical staining. RESULTS: OMM samples from 4 patients were implanted subcutaneously and passaged for expansion successfully. Histopathologically and immunohistochemistrically, PDX models showed similar morphology and HMB-45, Melan-A, S-100 and Ki-67 protein expression to the primary tumor. CONCLUSIONS: Four xenograft models were successfully established, in which the histopathological and molecular features of the primary tumors are preserved through passaging, which provid promising preclinical models for translational research of OMM. References | Related Articles | Metrics

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Effect of blood glucose control on the stability of implant and the indexes of blood inflammation in patients with type 2 diabetes mellitus ZHANG Xiao-dong, LIU Xi, ZHANG Min-zhu, WANG Min, ZHU Kun 2017, 15 (6):  488-492.  doi: 10.19438/j.cjoms.2017.06.011 Abstract ( 271 )   PDF (3721KB) ( 283 )   PURPOSE: To investigate the effect of blood glucose control on the stability of the implant and the indexes of blood inflammation in type 2 diabetes mellitus. METHODS: From July 2014 to July 2015, 30 patients with type 2 diabetes undergoing dental implantation were chosen as the experimental group, while 30 patients with normal blood glucose who underwent dental implantation were chosen as control group. Blood glucose control level, implant stability and blood inflammatory markers were compared between the two groups using SPSS 18.0 software package. RESULTS: Preoperatively inflammatory markers were not significantly different (P>0.05) between the two groups; 24 h postoperatively, inflammatory indexes in the experimental group were significantly higher than those in the control group (P<0.05); postoperative ISQ decreased rapidly and then raised, but no difference was found at each time point in 2 groups (P>0.05); maximum decrease of ISQ in patients with blood glucose >7.5% was lower than in patients with blood glucose less than or equal to 7.5%, and the recovery time of ISQ was significantly longer. CONCLUSIONS: The level of blood glucose control in type 2 diabetes mellitus is closely related to the stability of dental implant and the indexes of blood inflammation. References | Related Articles | Metrics

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Research on wound healing and variation of hypertrophic scar in rabbit after cleft lip surgery LIU Feng, ZHANG Dai-zun, XIAO Wen-lin, XUE Ling-fa, XU Yao-xiang 2017, 15 (6):  493-497.  doi: 10.19438/j.cjoms.2017.06.003 Abstract ( 725 )   PDF (3468KB) ( 234 )   PURPOSE: To observe the hyperplasia trend of hypertrophic scar after cleft lip surgery in rabbits, and to explore the exact time of the largest degree of hypertrophic scar after cleft lip repair, which provided a theoretical basis for the study of the most effective time of gene therapy for hypertrophic scars. METHODS: Forty New Zealand white rabbits from the same offspring were used to make wound healing model in cleft lip Millard's procedure. The volumes were measured respectively and granulation tissues were observed visually at 2nd week, 3rd week, 4th week and 5th week after operation. The rabbits were sacrificed and scar tissues were harvested in the indicated time. Immunohistochemical paraffin section (IHC-P), myofibroblast (MFB) cell count and Western blot were performed to detect the expression level of α-smooth muscle actin (α-SMA) in the scar tissue. SPSS 18.0 software package was used for statistical analysis. RESULTS: The results showed that the scar contraction was significant at 3rd and 4th week, comparing to 2nd and 5th week after surgery. The degree of scar hyperplasia after surgery was approximately in normal distribution. CONCLUSIONS: MFBs were important cells in scar formation and α-SMA was an important marker of MFBs. The study provides an objective basis for determination of scar severity by measuring the protein expression of α-SMA. References | Related Articles | Metrics

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Exploration of a pathway for sinus augmentation in Beagle dogs LIN Hai-yan, WANG Ren-fei, YU Yan-chun, DENG Li-quan, ZHANG Wei-dan, LIN Zheng-yu 2017, 15 (6):  498-502.  doi: 10.19438/j.cjoms.2017.06.004 Abstract ( 570 )   PDF (3804KB) ( 258 )   PURPOSE: To establish a Beagle model, which was used to explore a new surgical pathway of sinus augmentation and analyze the effect of implantation of artificial bone substitutes. METHODS: Eleven male Beagle dogs (17 months, weighing 12-14 kg) were chosen with 22 maxillary sinus. Bilateral cone-beam CT (CBCT)scans were taken under intravenous anesthesia, to locate the range of the maxillary sinus, analyze the anatomical structure of the maxillary sinus wall, so as to make a plan of teeth extraction and measure the height and anteroposterior diameter of the sinus. A second CBCT scan was performed 2 months after extraction, to measure the height and the anteroposterior diameter of the bilateral maxillary sinus, in order to determine the volume of the artificial bone substitute, measure the distance from the bottom of the sinus to the crest(hereinafter referred to as the distance from B to C), and analyze the pathway. Fenestration of the maxillary sinus wall was conducted under general anesthesia and tracheal intubation, and the subjects were divided into 3 groups by implanting 3 kinds of artificial bone substitutes as designed (BioCap coating group, BioCap group and Bio-Oss group). The animals were sacrificed after taking the third CBCT scan 3 months after operation to test the bilateral maxillary sinus and sampled for analysis. The differences were analyzed with SPSS 19.0 software package for LSD test. RESULTS: It was found that the presence rate of thick infraorbital nerve bundles outside the maxillary sinus on CBCT was 100%. The maxillary sinus was located above the maxillary canine and the mesial root of third molar. The height of sinus was (8.10±1.05) mm, the anteroposterior diameter was (20.87±1.51)mm before teeth extraction. The height was (8.15±1.01)mm, the anteroposterior diameter was (20.89±1.21)mm, the distance from B to C in the middle of the sinus was (4.16±0.85)mm 2 months after teeth extraction. 1.2 mL artificial bone substitute were implanted into each sinus. The anteroposterior diameter was (20.86±1.27) mm, the distance from B to C in the middle of the sinus was (7.16±0.76)mm, the osteogenesis percentage was 85.15%±6.76% in BioCap coating group, 35.14%±6.13% in BioCap group, and 33.16%±6.75% in Bio-Oss group, 3 months after windowing. Statistical analysis showed that the distance from B to C after surgery was significantly higher than that before surgery (P<0.01). Osteogenic percentage in BioCap coating group was significantly higher than that in BioCap group and Bio-Oss group (P<0.01). There was no significant difference between BioCap group and Bio-Oss group (P>0.05). CONCLUSIONS: There was a large infraorbital nerve vascular bundle outside the maxillary sinus of Beagle dog which needed to open two layers of bone window to get into the sinus. Implanting artificial bone substitutes by opening a window outside the maxillary sinus of Beagle dogs could significantly increase the distance from the bottom to the crest, and could be used as animal models for maxillary sinus surgery. References | Related Articles | Metrics

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Biomechanical analysis of three-dimensional printing titanium alloy craniomaxillofacial bone plate WEI Hong-pu, YU Jing-shuang, JIANG Teng-fei, LI Xiang, WANG Xu-dong 2017, 15 (6):  503-507.  doi: 10.19438/j.cjoms.2017.06.005 Abstract ( 267 )   PDF (3820KB) ( 608 )   PURPOSE: To study the mechanical properties of titanium alloy craniomaxillofacial bone plate manufactured by two kinds of three-dimensional printing techniques and compare with conventional titanium plate. METHODS: Stereolithography data (STL) of conventional titanium plates were obtained and used to fabricate bone plate by selective laser melting (SLM) and electron beam melting (EBM). Static mechanical test and Rockwell hardness test of the conventional titanium plate, SLM titanium plate and EBM titanium plate were carried out. The SPSS13.0 software package was used to analyze the data. RESULTS: All the tests were successfully completed. Variance analysis showed that the yield load was SLM>EBM>conventional plate, and the maximum load was SLM>EBM>conventional plate, the difference was statistically significant. Rockwell hardness test results was SLM> conventional plate>EBM, multiple comparison showed that the difference of the two techniques and conventional plate was not statistically significant. CONCLUSIONS: The preliminary results show that three-dimensional printing titanium alloy plate has nice biomechanical properties, and its mechanical strength and hardness meet the national and industrial standards. References | Related Articles | Metrics

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MRI evaluation of disc status changes of anterior displacement with reduction and without reduction HU Ying-kai, YANG Chi, CAI Xie-yi, XIE Qian-yang 2017, 15 (6):  508-514.  doi: 10.19438/j.cjoms.2017.06.006 Abstract ( 876 )   PDF (5276KB) ( 612 )   PURPOSE: The aim of the study was to evaluate disc status changes of anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR),in order to get a better understanding of the disease progress without intervention. METHODS: This longitudinal retrospective study included 217 joints in 165 patients, which were divided into ADDWR group and ADDWoR group based on magnetic resonance imaging (MRI). The joints were assessed quantitatively for disc length and displacement distance at initial and follow-up visits. Disc morphology, which was classified into 5 types, as well as Wilkes stages were also evaluated. Paired t test and Wilcoxon signed rank test were used to assess intra-group differences and independent t test for inter-group differences using SPSS 17.0 software package. RESULTS: There were 86 joints in ADDWR group and 131 joints in ADDwoR group. The follow-up interval was 9.38 months in ADDWR group, compared to 8.54 months in ADDWoR group. Discs tended to become shorter, move further forward and distort more seriously in ADDWoR group than in ADDWR group during follow-up period. Type I disc morphology dominated in ADDwR group both at first and follow-up visits, demonstrating great value of disc repositioning. However, major disc morphology changed from type II to type IV in ADDWoR group, indicating decrease of the value of disc repositioning. CONCLUSIONS: Discs tended to become shorter, move further forward and distort more seriously, especially in ADDWoR group, which reminds TMJ surgeons to perform disc repositioning surgery as soon for ADDWoR patients with risk factors, instead of nonsurgical surgery for 6 months that may lead to serious deterioration in disc status. References | Related Articles | Metrics

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Application of 3D printing technology for improved reconstruction in orbital floor defect SUN Shao-long, LAI Qing-guo, TANG Xiao-peng, CI Jiang-bo, LI Yan, XUE Run-qi, ZHANG Zhi-chao 2017, 15 (6):  515-518.  doi: 10.19438/j.cjoms.2017.06.007 Abstract ( 311 )   PDF (3364KB) ( 289 )   PURPOSE: The aim of this study was to evaluate the validity of 3D printing technology for improved reconstruction in orbital floor defect. METHODS: Individual 3D disease models and mirror-imaged 3D reconstruction models were printed on the basis of the CT data. Preoperative planning by rehearsing surgical procedures was made on the 3D disease models and the scaffolds including titanium and absorbable meshes or plates were anatomically pre-molded using the mirror-imaged 3D models as guide. RESULTS: Precise reconstruction was achieved on all patients with improved cosmetic outcomes of craniomaxillofacial shapes. There were no diplopia, infection, foreign body reaction, exophthalmos, enophthalmos after surgery. CONCLUSIONS: Orbital floor reconstruction can be optimized and successful through preoperative planning and pre-molded scaffolds with 3D printing bone model by computer-aid design and manufacturing. References | Related Articles | Metrics

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Clinical effect of micro screw implant anchorage in the treatment of adult patients with double jaw protrusion GUO Zhong-jun, ZHOU Hong, LI Rui-chun, HAN Feng-qin 2017, 15 (6):  519-523.  doi: 10.19438/j.cjoms.2017.06.008 Abstract ( 267 )   PDF (3705KB) ( 280 )   PURPOSE: To investigate the clinical effect of micro screw implant anchorage in the treatment of adult patients with double jaw protrusion. METHODS: A total of 100 adult patients with bimaxillary protrusion were stratified into micro screw implant anchorage group (n=50) and extraoral anchorage group (n=50) according to different treatment methods. The differences of lip protrusion, upper alveolar protrusion and lower alveolar protrusion, dentition,mandible and maxilla were evaluated after treatment. SPSS 19.0 software package was performed for data analysis. RESULTS: The treatment duration of micro screw implant anchorage group and extraoral anchorage group was (18.84±2.61) month and (24.72±2.32) months, respectively, which was significantly different (P<0.05). The difference of upper lip protrusion, lower lip protrusion, upper lip-E line, lower lip-E line and lip gap before and after treatment were significant between 2 groups. The differences of the upper incisors protrusion, lower incisors protrusion, the upper central incisors angle, the lower central incisors angle, upper alveolar protrusion and lower alveolar protrusion before and after treatment in micro screw implant anchorage group were significantly greater than those in extraoral anchorage group (P<0.05). CONCLUSIONS: The clinical effect of micro screw implant anchorage in the treatment of adult patients with double jaw protrusion deformity is significant, which is worthy of clinical application. References | Related Articles | Metrics

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Soft and hard tissue changes after bimaxillary surgery in osseous class Ⅲ patients HU Zhao-ni, QU Wei-guo, LI Yang, QIU Gang, WANG Ji, YUE Bai 2017, 15 (6):  524-528.  doi: 10.19438/j.cjoms.2017.06.009 Abstract ( 476 )   PDF (3890KB) ( 199 )   PURPOSE: To investigate the changes of soft and hard tissue after bimaxillary surgery in osseous Class Ⅲ patients, in order to predict postoperative soft tissue profiles. METHODS: Twenty-six adults patients were selected as the experimental group, cone-beam CT (CBCT) scans were conducted. InVivo 5 software was used to transform CBCT into cephalogram from CBCT(CCB) which were imported into the software named Geometer's Sketchpad. All points were measured in the system of rectangular coordinates and were used for statistical analysis SPSS17.0 software package. RESULTS: There was a linear relationship between soft and hard tissue. The correlation in mandible was stronger than that in maxilla, Sn:A=0.18:1, UL:Ui=0.31:1, LL:Li=0.80:1,Si:B=0.84:1,Pg':Pg=0.90:1. There was no correlation between the thickness of nasal floor and the changes of the soft and hard tissue. The same was the thickness of chin. There was negative correlation in the thickness of lip with the soft and hard tissue changes. The upper lip became thinner, the lower lip became thicker. CONCLUSIONS: There was a linear correlation between the hard tissue and the soft tissue. The correlation and ratio of mandible was stronger than maxilla. Changes of hard tissue had major effects on the soft tissue of nasal floor and chin, but minor effects on lip. There was better mobility in thinner upper lip than thicker lip. References | Related Articles | Metrics

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Evaluation of the efficacy and safety of 0.5% timolol maleate solution or oral propranolol in the treatment of superficial infantile hemangiomas ZHANG Kai-chi, XU Da-peng, CHENG Mo-sha, WANG Xu-kai 2017, 15 (6):  529-533.  doi: 10.19438/j.cjoms.2017.06.010 Abstract ( 557 )   PDF (3818KB) ( 322 )   PURPOSE: To investigate the clinical effects of 0.5% timolol maleate solution or oral propranolol in treating superficial infantile hemangiomas. METHODS: A total of 50 patients with superficial infantile hemangiomas were retrospectively analyzed, 27 cases received topical 0.5% timolol maleate solution alone (group A), and 23 cases received oral propranolol alone (group B). Patients were followed up for 12 months. SPSS18.0 software package was used to compare the difference of therapeutic efficacy, the response time and adverse reactions between group A and group B. RESULTS: The effectiveness of group A and group B was 63.0%and 65.2%, respectively. The therapeutic efficacy and response time after 12 months had no significant difference between group A and B (P>0.05). Compared with group B, group A had fewer adverse reactions（P<0.05）. No serious adverse effects were encountered in both groups. CONCLUSIONS: Topical 0.5% timolol maleate solution is effective and safe in the treatment of superficial infantile hemangiomas. It could be considered as the first-line treatment especially for superficial infantile hemangiomas. References | Related Articles | Metrics

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Comparison of the pullout force of two kinds medical anchoring nails implanted in the condyle SUN Shou-fu, ZHEN Jin-ze, ZHANG Shan-yong, LIU Xiu-ming, ZHENG Ji-si, XU Wei-feng, SHEN Pei, LI Hui-ping, GUO Ke, ZHONG Xiao-qi 2017, 15 (6):  534-537.  doi: 10.19438/j.cjoms.2017.06.002 Abstract ( 420 )   PDF (2920KB) ( 187 )   PURPOSE: To compare and analyze the pullout force and form of the traditional anchoring nail and modified anchoring nail, which were placed in the inferior border of mandibular condyle during open surgery of TMJ anchorage. METHODS: Ten resected condyles were obtained from patients with TMJ replacement due to TMJ osteoarthrosis. Traditional and modified anchoring nails with 3-0 anchoring lines, modified anchoring nail with 2-0 anchor line were implanted respectively in the cortical bone of the inferior border of mandibular condyle. Each group contained 20 nails and was tested by tensile tester to observe the cortical bone damage, anchor nail breakage or loosening and line fracture. The data were analyzed with SPSS17.0 software package. RESULTS: During the two kinds of medical anchoring nail implantation and tensile test, bone cortex damage, anchoring nail fracture and loosening did not occur, except line fracture. Maximum tensile force of traditional nails with 3-0 anchoring lines, modified anchoring nails with 3-0 anchoring lines and modified anchoring nails with 2-0 anchoring lines was (27.53±5.47) N, (25.89±2.64) N and >50 N, respectively. There was significant difference between traditional and modified anchoring nail with 3-0 anchoring line (P<0.05), there was also significant difference between traditional anchoring nail with 3-0 anchoring line and modified anchoring nail with 2-0 anchoring line. CONCLUSIONS: Both conventional and modified medical anchoring nails can be successfully implanted into the condylar neck without nail fractures and damaging the condylar neck cortical bone. The modified anchoring nails are more competent in adapting the condyle anatomical shape, and proven to be safer and more comfortable. Furthermore, the 2-0 anchored line can withhold a higher pull force than the conventional anchoring nails. References | Related Articles | Metrics

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Analysis on pathogenic microorganism and drug-resistance of severe oral and maxillofacial infections in ICU WANG Hai-yun, ZHOU Long-nv, ZHU Hong 2017, 15 (6):  538-542.  doi: 10.19438/j.cjoms.2017.06.012 Abstract ( 302 )   PDF (3954KB) ( 266 )   PURPOSE： To investigate the pathogenic distribution and drug resistance characteristics of severe oral and maxillofacial infections in ICU, and to provide evidence for clinical rational use of antibiotics. METHODS: Eight-nine patients with severe oral and maxillofacial infections in ICU were chosen from January, 2010 to December, 2016. The strains from each patient were cultured and identified respectively. Each stain was used to test drug susceptibility. RESULTS: One hundred and thirty strains of pathogenic bacteria were isolated from 89 patients , including 66 strains of gram-negative bacteria,accounting for 50.77%; 59 strains of gram-positive bacteria, accounting for 45.38%; 5 strains of fungi,accounting for 3.85%. Drug susceptibility test showed that the Klebsiella pneumoniae and Escherichia coli were susceptible to imipenem, sulbactam and cefoperazone and tazobactam sodium. Prevotella was susceptible to metronidazole imipenem and sulbactam and cefoperazone. Staphylococcus aureus, Viridans Streptococci and Enterococcus were susceptible to linezolid and vancomycin. Most pathogens were resistant to many antibiotics. CONCLUSIONS: Severe oral and maxillofacial infections in ICU were mainly caused by gram-negative bacteria. Most pathogenic bacteria are resistant to many antibiotics, which suggests that more reasonable use of drug should be performed to prevent drug resistance in clinical treatment. References | Related Articles | Metrics

Clinical Reports

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Clinical and pathological analysis of oral tuberculosis in 11 consecutive cases JU Wu-tong, LIU Ying, TAN Yi-ran, YIN Xue-lai, DONG Min-jun, WANG Li-zhen, LI Jiang, ZHONG Lai-ping 2017, 15 (6):  543-547.  doi: 10.19438/j.cjoms.2017.06.013 Abstract ( 317 )   PDF (4047KB) ( 258 )   PURPOSE: To analyze oral tuberculosis in terms of clinical appearance, clinical differential diagnosis, treatment and prognosis. METHODS: From November 2012 to June 2016, eleven patients with oral tuberculosis were treated. The patients' general condition, clinical symptoms and signs, imaging modalities, pathological files, treatment and prognosis were collected and analyzed. RESULTS: Among 11 patients, there were 6 males and 5 females with a mean age of 59.1 years, ranging from 48 to 78 years old. Five patients presented ulceration (four in gingiva and one in buccal region), four patients presented mass (one in gingival and three in buccal region), one patient presented osteomyelitis; only one patient presented enlargement of cervical lymph nodes. Five patients' chest radiography showed sequelae of pulmonary tuberculosis. Two of ten patients received drug therapy after surgical biopsy, and eight patients received surgical resection of mass in the oral cavity. After being diagnosed as oral tuberculosis by pathological examination, six patients received purified protein derivative examination, and four of them received drug therapy against tuberculosis. The mean follow-up period was 24.9 months ranging from 8 to 48 months, with one patient loss to follow-up, no lesion recurrence was found during the follow-up period. CONCLUSIONS: Oral tuberculosis is rare, with no specific clinical appearance. Pathology and other examinations are necessary for diagnosis of oral tuberculosis. The treatment of oral tuberculosis is suggested as surgical resection or surgical resection combined with drug therapy against tuberculosis. The prognosis of oral tuberculosis is fine. References | Related Articles | Metrics

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Treatment of maxillofacial fractures with rigid internal fixation: report of 115 cases GAO Zhen-ran, MA Song-bo, ZHANG Guo-qin 2017, 15 (6):  548-550.  doi: 10.19438/j.cjoms.2017.06.014 Abstract ( 259 )   PDF (2204KB) ( 293 )   PURPOSE: To analyze and summarize the experience of rigid internal fixation for 115 patients with maxillofacial fractures. METHODS: A retrospective study was conducted in 115 patients with maxillofacial fractures from January 2014 to December 2016. The experience of open reduction and rigid internal fixation were summarized and analyzed. RESULTS: One hundred and fifteen patients with maxillofacial fractures were treated by rigid internal fixation. 109 patients had satisfied functional and esthetic results (94.8%). CONCLUSIONS: Rigid internal fixation is a reliable method to treat maxillofacial fractures. References | Related Articles | Metrics