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    20 May 2019, Volume 17 Issue 3 Previous Issue    Next Issue
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    Original Articles
    Effects of puerarin on osteoclast differentiation of marrow-derived macrophages from mandible
    MA Xu-hui, ZHANG Peng, YANG Yi-ling, XU Hong-yuan, GONG Xin-yi, ZHOU Si-ru, JIANG Ling-yong, DAI Qing-gang
    2019, 17 (3):  193-197.  doi: 10.19438/j.cjoms.2019.03.001
    Abstract ( 183 )   PDF (3600KB) ( 169 )  
    PURPOSE: To study the effect of puerarin on osteoclast differentiation of marrow-derived macrophages (BMMs) from mandible. METHODS: BMMs were obtained from 4-week-old female SD rats. Cell viability of BMMs with different concentration of puerarin was determined by CCK-8. Tartrate resistant acid phosphatase staining and q-PCR were used to analyse the changes of osteoclast formation and expression of osteoclast gene of BMMs due to different concentration of puerarin. Statistical analysis was performed using SPSS 16.0 software package. RESULTS: Cell viability of BMMs with puerarin at 1 nmol/L, 10 nmol/L, 100 nmol/L, 1 μmol/L and 10 μmol/L showed no difference from the control group, and 100 μmol/L group displayed decreased cell viability (P<0.05). Osteoclast number and relative osteoclast surface reduced in BMMs with 10 nmol/L, 100 nmol/L and 1 μmol/L puerarin in comparison with the control group. Furthermore, the expression of NFATc1, C-fos, TRAP and CTSK deceased in BMMs with 10 nmol/L, 100 nmol/L, and 1 μmol/L puerarin. CONCLUSIONS: Puerarin could impede osteoclast differentiation of mandibular BMMs, which may be used to prevent and treat osteoporosis in alveolar and jaw bone.
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    Preliminary screening and validation of cyclin D1 co-expressed long non-coding RNAs in human pleomorphic adenoma
    WEI Jun-shui, LU Hao, YANG Wen-jun, SHEN Shu-kun, XU Wan-lin
    2019, 17 (3):  198-203.  doi: 10.19438/j.cjoms.2019.03.002
    Abstract ( 125 )   PDF (4461KB) ( 78 )  
    PURPOSE: To screen out and validate the differentially expressed long non-coding RNAs (LncRNAs) that co-expressed with cyclin D1 in human pleomorphic adenoma. METHODS: The expression of cyclin D1 in human pleomorphic adenoma was first validated through real time-PCR, Western blot and micro-array analysis. The differentially expressed LncRNAs from the micro-array results that co-expressed with cyclin D1 were screened out via calculating the Pearson's correlation coefficient (PCC), and then the expression of three randomly selected lncRNAs (GSE61474_TCONS_00180431, ENST00000603829 and T253381) were validated with real time PCR. Statistical analysis was completed with SPSS 19.0 software package. RESULTS: The expression of cyclin D1 was significantly up-regulated in human pleomorphic adenoma than the controls (P<0.05). A total of 9 LncRNAs that co-expressed with cyclin D1 were screened out, among which, 6 were up-regulated and 3 were down-regulated. Real-time PCR results demonstrated that same expression trends of the three selected LncRNAs were shown with micro-array results. However, only ENST00000603829 expressed significantly in the subsequent enlarged tumor samples (P<0.05). CONCLUSIONS: The differentially expressed LncRNAs that co-expressed with cyclin D1 were screened out and validated in human pleomorphic adenoma. These LncRNAs could play important roles in pathogenesis and development of pleomorphic adenoma, possibly through interacting with cyclin D1.
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    Establishment of a new cell line of oral squamous cell carcinoma cell: TSCC2016
    ZHU Dong-wang, SUN Wen-wen, ZHAO Tong-chao, ZHONG Lai-ping, ZHANG Chen-ping, ZHANG Zhi-yuan
    2019, 17 (3):  204-209.  doi: 10.19438/j.cjoms.2019.03.003
    Abstract ( 228 )   PDF (4719KB) ( 150 )  
    PURPOSE: To establish a new cell line of oral squamous cell carcinoma(OSCC), and explore its biological characteristics. METHODS: Fresh tumor tissue from a female patient, which was pathologically confirmed to be oral squamous cell carcinoma (OSCC), was collected during surgery. Tissue sample was cut into small pieces and cultured in nutrient solution. A new cell line of oral squamous cell carcinoma (TSCC2016) was established, and its cellular morphology was described. Cell proliferation, epithelial cell differentiation, tumorigenicity, and cell karyotype were examined. The data were analyzed with SPSS13.0 software package. RESULTS: TSCC2016 was successfully established and subcultured for more than 100 passages. TSCC2016 cells had characteristics of polygonal epithelial cell, epithelial cell differentiation, and good tumorigenicity. STR analysis showed that TSCC2016 cells were primarily cultured OSCC cells without any other cell line contamination. CONCLUSIONS: The new cell line of OSCC cell line (TSCC2016) is a stable cell line for further basic research.
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    Surface and internal morphological analysis of three-dimensional titanium alloy craniomaxillofacial bone plate
    WEI Hong-pu, YINGWANG Jun-zi, YU Jing-shuang, JIANG Teng-fei, LI Xiang,WANG Xu-dong
    2019, 17 (3):  210-215.  doi: 10.19438/j.cjoms.2019.03.004
    Abstract ( 219 )   PDF (4779KB) ( 125 )  
    PURPOSE: To study the surface and internal morphology 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). Part of the titanium plate was selected for surface polishing treatment. The roughness and internal defects of the unpolished SLM titanium plate, EBM titanium plate and the polished SLM titanium plate, EBM titanium plate together with conventional titanium plate were examined. Relevant images and data were obtained for image description and further statistical analysis with SPSS13.0 software. RESULTS: The three-dimensional printing titanium plate had a large roughness. However, the surface roughness can be significantly reduced by surface polishing. After surface polishing process, the roughness declined significantly and met the standards of the national industry standards. After surface polishing process, there was no significant difference of the surface roughness between the three-dimensional printing titanium plate and the conventional bone plate. As regard to internal defect, there was no obvious defect in the three types of bone plates, which met the requirements of the national industry standards and clinical application. CONCLUSIONS: The three-dimensional printing titanium alloy craniomaxillofacial bone plate has nice surface and internal morphology, and its surface roughness and internal defects basically meet the national industry standards.
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    Application of double stained immunohistochemistry technology in lymphoepithelial lesions of salivary gland
    GU-Ting, HU Yu-hua, XIA Rong-hui, TIAN Zhen, WANG Li-zhen, ZHANG Chun-ye, LI Jiang
    2019, 17 (3):  216-220.  doi: 10.19438/j.cjoms.2019.03.005
    Abstract ( 159 )   PDF (4088KB) ( 93 )  
    PURPOSE: Depending on the sites of positive antibody expression (nucleus, cytoplasm and membrane), this study was aimed to investigate the best method of applying double stained immunohistochemistry technology in lymphoepithelial lesions of salivary gland. METHODS: The expression of AE1/AE3,Ki-67 and CD20cy was examined by single stained immunohistochemistry and double stained immunohistochemistry respectively in 20 benign lymphoepithelial lesions (BLEL), 20 lymphoepithelial carcinomas (LEC) and 20 extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT) . Depending on the different sites of antibody expression (nucleus, cytoplasm and membrane), the sequence of staining and chromogenic system, three methods of double stained immunohistochemistry were performed: ① Ki-67(DAB chromogen),AE1/AE3 or CD20cy(AEC chromogen); ②AE1/AE3 or CD20cy(DAB chromogen),Ki-67(AEC chromogen); ③ Ki-67(AEC chromogen),AE1/AE3 or CD20cy(BCIP/NBT chromogen). The results of double stained immunohistochemistry were compared with single stained immunohistochemistry. The data were analyzed by using SPSS 17.0 software package. RESULTS: The results of immunohistochemistry demonstrated specificity and accuracy of the immunostaining procedures in all three methods, no significant difference of the positive strength (P=0.765) and positive ratio of antibody (P>0.05) was found in method 1. Otherwise, there were significant differences of the positive strength and positive ratio of antibody in method 2 and 3 (P<0.05). CONCLUSIONS: The best method is that nucleus positive antibody should be chosen first (Ki-67), followed by DAB chromogen, cytoplasm and membrane positive antibody should be chosen second(AE1/AE3 or CD20cy), combined with AEC chromogen for double stained immunohistochemistry in lymphoepithelial lesions of salivary gland.
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    Accuracy of digital models reconstructed by cone-beam CT under different segmentation thresholds
    SHEN Yu-qing, LIU Wen-juan, SUN Jian, YU You-cheng, ZHOU Qian-rong, XU Yi
    2019, 17 (3):  221-224.  doi: 10.19438/j.cjoms.2019.03.006
    Abstract ( 168 )   PDF (3284KB) ( 166 )  
    PURPOSE: To compare the accuracy of digital models reconstructed by cone-beam CT(CBCT) under different segmentation thresholds (STs). METHODS: A total of 20 patients who had CBCT images for diagnostic purposes were included in this study. Three-dimensional digital models were reconstructed by CBCT scans using different STs(based on gray value (GV) from 200 to 1800,gap 200)with Mimics 15.01. Plaster models were obtained, and mesiodistal diameter of each tooth was measured in all models. Paired t test was used to evaluate the accuracy of the digital models in comparison to the plaster models. Scatter plots and intraclass correlation coefficient (ICC) were also used to evaluate the correlation between the models with SPSS 16.0 software package. RESULTS: The mean difference between digital models and plaster model was from-0.36 mm to 0.32 mm. There was no significant difference between the plaster model and the digital models reconstructed under ST GV 1200 and 1400 (P>0.01). The measurements of digital models reconstructed under other STs were different from the plaster ones (P<0.01). ICCs between digital models and plaster model were all >0.95. CONCLUSIONS: The accuracy of CBCT reconstructed 3-dimensional digital model is influenced by different STs. Therefore, selection needs to be made in clinical application.
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    Ultrasound elastography in diagnosis and follow-up for patients with IgG4-related sclerosing sialadenitis
    WANG Zhi-jun, ZHANG Wei-qian, ZHENG Ling-yan, CAO Ning-ning, SHI Huan, XIE Li-song, YU Chuang-qi
    2019, 17 (3):  225-229.  doi: 10.19438/j.cjoms.2019.03.007
    Abstract ( 233 )   PDF (4454KB) ( 106 )  
    PURPOSE: This study was aimed to explore the utility of ultrasound elastography in diagnosis and follow-up of IgG4-related sclerosing sialadenitis. METHODS: We retrospectively studied IgG4-related sclerosing sialadenitis patients based on clinical examination, serology, pathology and ultrasound elastography features. The bilateral submandibular glands were examined by strain ratio(SR) and acoustic radiation force impulse(ARFI) imaging, and the SR and shear wave velocity (SWV) value were obtained. All the patients were treated by corticosteroids and followed up for at least one month. RESULTS: Three patients with IgG4-related sclerosing sialadenitis were involved in the study. The patients presented persistent bilateral and painless submandibular glands swelling, elevated levels of serum IgG4 and IgG4-positive plasmacytes infiltration with tissue fibrosis. Elastography revealed ''blue'' area meaning to be hard tissue matched the hypoechoic areas within the enlarged submandibular glands before treatment. The SR value was lower and the SWV value was higher than normal controls, which meant the gland tissue was stiffer than normal. After one month's steroids treatment, obvious regression of gland swelling and decrease of serum IgG/IgG4 level were observed. Elastography showed ''blue'' area was shrinking and "yellow/green" area was expanding. The SR value was higher and the SWV value was lower, which meant the gland tissue was softer than before. CONCLUSIONS: Ultrasound elastography provides an easy, quick and non-invasively safe method for objective and semi-quantitative assessment of salivary gland involvement in the diagnosis and follow-up of IgG4-related sclerosing sialadenitis. A comprehensive understanding of ultrasound elastography, clinical condition, serum IgG/IgG4 level change and histopathologic manifestation can assist the diagnosis and lead to the preliminary assessment of disease severity and progression in patients with IgG4-related sclerosing sialadenitis.
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    The effect of thickness of labial bone and angulation of mandibular anterior teeth on preoperative design of immediate dental implants
    LI Jing-hua, JIANG Wen-jing, WANG Yan-hui, LI Xiao-jing, BAI Na
    2019, 17 (3):  230-234.  doi: 10.19438/j.cjoms.2019.03.008
    Abstract ( 282 )   PDF (3721KB) ( 184 )  
    PURPOSE: This study aimed to measure the thickness of labial bone and the angulation of mandibular anterior teeth using cone-beam CT (CBCT) for preoperative design of immediate dental implants. METHODS: CBCT images from 135 patients (67 males, 68 females) with complete mandibular permanent teeth were selected from Affiliated Hospital of Qingdao University. The thickness of labial bone at alveolar bone crest (P1), the middle point of root (P2), the apex of root (P3), and the angle between the long axis of lower anterior teeth and the alveolar bone were measured. SPSS 23.0 software package was used for statistical analysis. RESULTS: The average thickness of labial bone at alveolar bone crest of mandibular central incisor, lateral incisor and canine was(0.65±0.24)mm, (0.66±0.28)mm, (0.57±0.29)mm, respectively; the average thickness of labial bone at the middle point of root of mandibular central incisor, lateral incisor and canine was(0.58±0.35)mm, (0.47±0.23)mm, (0.58 ±0.30)mm, respectively; and the average thickness of labial bone at the apex of root of mandibular central incisor, lateral incisor and canine was (3.45±1.28)mm, (3.87±1.25)mm, (4.60±1.32)mm, respectively. The mean angles of the long axis of mandibular central incisor, lateral incisor, canine and alveolar bone were 5.43°±2.30°, 7.22°±3.12°, 6.28°±2.65°, respectively. There was no significant difference in individual measurements between both sides and genders. CONCLUSIONS: The thickness of the labial bone of the mandibular anterior teeth is thin, the angle of mandibular anterior tooth inclination is small, which provides a reference basis for immediate dental implant treatment plan in the mandibular anterior teeth.
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    Clinical outcomes over 3-5 years of short implant(≤6 mm) supporting single crown in posterior jaws
    MO Jia-ji, QIAO Shi-chong, ZHANG Xiao, ZHU Yu, ZHANG Xiao-meng, SHI Jun-yu, QIAN Shu-jiao, LAI Hong-chang
    2019, 17 (3):  235-239.  doi: 10.19438/j.cjoms.2019.03.009
    Abstract ( 297 )   PDF (4127KB) ( 74 )  
    PURPOSE: To evaluate the clinical and radiographic outcomes over 3-5 years of short implants supporting single crown in the posterior jaws. METHODS: The clinical and radiographic data of 118 short implants(intra-bony length≤6 mm) supporting single crown were collected 3-5 years after restoration. Implant and prosthesis failures, peri-implant marginal bone loss, biological and technical complications were evaluated. The influencial factors on implant failure were also evaluated. The data were analyzed using SPSS 17.0 software package. RESULTS: Nine implants and 15 protheses failed. The 5-year cumulative survival rate was 92.4%. The short implant placed in type Ⅳ bone yielded more failure than in typeⅠ-Ⅲ and presented a survival rate of 80%. The mean marginal bone loss between crown installation and the 5th year follow-up visit was (0.63±0.68)mm. The marginal bone loss in the first year was (0.63±0.10)mm, without significant difference. Nine(7.6%) implants were exposed to biological complications, whereas 15 (12.7%) implants suffered from technical complications. CONCLUSIONS: High survival rates could be achieved over 3-5 years for short implants supporting single crown. However, long term outcomes of short implants is still scarce and caution should be taken when short implants are planned at the type Ⅳ bone.
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    Study of alveolar bone morphometry in aesthetics area
    WAN Shao-nan, YANG Chi, PU Yi-ping
    2019, 17 (3):  240-246.  doi: 10.19438/j.cjoms.2019.03.010
    Abstract ( 286 )   PDF (4978KB) ( 131 )  
    In this study, the risk factors that may cause aesthetic risk of the immediate implant were explored through the measurement of alveolar bone morphometry, and different classifications of the alveolar bone morphometry were summarized to provide different clinical opinions for preoperative evaluation, in order to provide a reference for preoperative evaluation and surgical selection for immediate implantation in the aesthetic area. METHODS: 100 patients were included in this study who were treated in our department from 2011 to 2017. Spiral CT was used to measure the morphological parameters of the alveolar bone in maxillary aesthetic areas, including the thickness of the buccal bone, the relationship between root and socket and the distance between tip of the root and the buccal sag area. The data were classified according to age, sex, with or without periodontitis and RCT. The data were analyzed with SPSS 19.0 software package. RESULTS: ①Canine's alveolar bone thickness (CD) was the greatest. The average CD value of the elderly group was smaller than that of the young and middle-aged group, and the female was smaller than the male. The average CD value of teeth with periodontitis were smaller than that of the healthy one's (P<0.05).②Central incisors' buccal bone in apex area (BE) was the greatest. BE of teeth with periodontitis and teeth after RCT was smaller than that of healthy teeth. Female's BE was smaller than that of male. The elderly group's BE was smaller than that of the young and middle-aged group (P<0.05). ③The angle between the incisor axis and the alveolar bone axis (β) was smallest in central incisors area, and the lateral incisors and canines were more inclined to the labial side. The difference between the three groups was statistically significant (P<0.05). In 570 anterior teeth, class Ⅰ relationship (β>10°) accounted for about 85%, class Ⅱ relationship (0°<β<10°) accounted for about 10%, class Ⅲ relationship (β<0°) accounted for 0% and the Ⅳ relationship accounted for about 5%. CONCLUSIONS: CT measurement of the bone morphology in maxillary anterior teeth before immediate implantation can effectively evaluate the conditions of the implantation site and reduce the probability of postoperative aesthetic risk.
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    Clinical analysis of 203 cases of infantile hemangioma treated by intralesional injection of a novel pingyangmycin
    LIU Xue-jian, LIU Zhi-peng, WU Yi-lei, TAI Mao-zhong
    2019, 17 (3):  247-250.  doi: 10.19438/j.cjoms.2019.03.011
    Abstract ( 194 )   PDF (3149KB) ( 115 )  
    PURPOSE: To summarize the clinical experiences of intralesional injection with a novel of pingyangmycin in the treatment of infantile hemangiomas, and to evaluate its clinical efficacy and safety. METHODS: Clinical data of 203 patients with infantile hemangiomas treated with a novel pingyangmycin injection from April 2016 to April 2017 were retrospectively analyzed. There were 54 males and 149 females. Median age was 10 months ranging 2 months to 6 years old. All 203 cases were classified into 5 types according to the classification methods reported by Liu Xue-jian et al. There were 33 cases of telangiectasis type, 52 of papule type, 59 of plump type, 37 of deep type and 22 of mixed type. There were 56 patients having received other treatments in the early stage, all of them responded poorly (including 38 patients receiving oral propranolol and 18 patients with laser therapy). Pingyangmycin injections were performed at a concentration of 1 mg/mL, and the injections did not stop until the tumors had swelling with slightly pale surface. The dose of pingyangmycin should not exceed 8 mg each time, and patients with large lesions were repeatedly injected at an interal of 1 month. The efficacy was evaluated on a 4-level scale proposed by Achauer et al. SPSS 18.0 software package was used for statistical analysis. RESULTS: After follow-up for 1 to 2 years, there were 167 grade Ⅳ cases, 31 grade Ⅲ cases, 5 grade Ⅱcases and 0 gradeⅠ case. There were significant differences in the efficacy among 5 different types. Papule type showed the best curative effect with a Ⅳ efficacy rate of 94.2%, followed by 93.9% in telangiectasis type, 91.5% in plump type, 51.7% in deep type and 43.4% in mixed type. Three children had mild pigmentation changes in the injection area. Fever occurred in 10 patients, but returned to normal 2 days later. There was no case of high fever, necrosis, allergic shock and pulmonary fibrosis. CONCLUSIONS: Injection of a novel pingyangmycin is recommended in the treatment of infantile hemangioma for its safety and effectiveness, especially for the treatment of lesions of papule, telangiectasis, and plump type.
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    Short-term therapeutic evaluation on bone augmentation technology without applying membrane in slight posterior buccal bone substitute implantation
    JIANG Shuai, JIANG Ya-ping, LI Xiao-jing, WANG Wen-xue, TENG Min-hua, LI Xin, ZHAO Bao-dong, MEI Dong-mei
    2019, 17 (3):  251-256.  doi: 10.19438/j.cjoms.2019.03.012
    Abstract ( 220 )   PDF (4565KB) ( 122 )  
    PURPOSE: To investigate the clinical effects of the technology without covering collagen membrane after bone grafting on posterior-region implant with small buccal bone substitute. METHODS: Patients who were subjected to posterior region implant surgery at Department of Implant, Affiliated Hospital of Qingdao University from February, 2017 to July, 2018 were selected. The implants were not exposed, and the distances from the buccal sides to the adjacent alveolar ridge were more than 1 mm. The patients were randomly divided into bone-grafting without membrane group (alloplastic bone substitute group, 30 cases) and bone-grafting with membrane covering group (GBR group, 30 cases). The horizontal bone mass variations of buccal alveolar ridge were obtained by comparing values in immediate post-surgery and 6 months after surgery through cone-beam CT (CBCT), from 0, 3 and 6 mm apical to implant platforms respectively, where were set as T1, T2 and T3, respectively. The evaluations on horizontal bone mass variations of alveolar ridge, peri-implant soft tissues and satisfaction degrees of the patients in two groups were compared and analyzed using SPSS 22.0 software package. RESULTS: According to the horizontal bone mass variations of alveolar ridge, the T1, T2 and T3 values of the alloplastic bone substitute group were (-0.48±0.73) mm, (-0.64±0.95) mm and (-0.30±0.84) mm, respectively; while the T1, T2 and T3 values of the GBR group were (-0.35±0.66) mm, (-0.49±0.74) mm and (-0.30±0.84) mm, respectively. The horizontal bone mass variations of alveolar ridge of two groups had no significant difference (P>0.05). Through reexamination 6 months after surgery, it was shown that all the peri-implant soft tissues in two groups were healthy. In addition, all the patients had high satisfaction degrees. CONCLUSIONS: For posterior implant with small buccal bone defects, the clinical effect is the same to GBR surgery simply through bone grafting, and healthy and stable soft tissues and high satisfaction degree can be obtained.
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    Early-warning function of C-reactive protein in diagnosis of descending necrotic mediastinitis
    XIA Yun-hui, QU Lu-yao, LIANG Xiang, JIANG Bin, QIAN Wen-tao, CAI Xie-yi, ZHANG Wei-jie, GUAN Xin
    2019, 17 (3):  257-260.  doi: 10.19438/j.cjoms.2019.03.013
    Abstract ( 138 )   PDF (3044KB) ( 123 )  
    PURPOSE: The aim of this study was to compare clinical information of patients suffering from oral and maxillofacial multiple space infection patients with or without descending necrotic mediastinitis (DNM), to analyze the risk factors for DNM, so as to provide clinical support for early diagnosis and treatment of descending necrotic mediastinitis. METHODS: This study was a prospective cohort study. The patients with severe oral and maxillofacial and cervical multiple space infections who were referred to the Department of Oral Surgery at Shanghai Ninth People's Hospital, Shanghai Jiao Tong Tong University School of Medicine from December 2016 to December 2017 were included. The clinical data were recorded, such as gender, age, source of original infection, laboratory test, occurrence of DNM. According to whether DNM occurred, the patients were divided into two groups. Continuous variables were compared by t or t' test between the two groups, and discrete variables were analyzed with Fisher's exact test using SPSS 22.0 software package. RESULTS: Two hundred and one patients with oral and maxillofacial and cervical multiple space infection during 12 months were enrolled. 14 patients developed DNM, and the occurrence was 6.97%. Among 201 patients, there were 142 males and 59 females. The average age of patients was 52.98±17.12 years. The most common causes were periapical periodontitis in 90 cases, accounting for 44.8%, followed by pericoronitis of wisdom teeth in 50 cases (24.9%). In addition, the most commonly site of primary source was mandibular posterior teeth in 140 cases (69.7%). After univariate analysis, the site of onset (P<0.001), neutrophil percentage (P=0.004), C-reactive protein (P<0.001) had significant relationship with DNM. CONCLUSIONS: Secondary DNM is more likely to occur in patients with high level of C-reactive protein and neutrophil percentage .
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    Effect of penehyclidine hydrochloride on cognitive function in elderly patients undergoing oral and maxillofacial surgery
    ZHAO Peng-cheng, LIU Jin-xing, JI Jun
    2019, 17 (3):  261-264.  doi: 10.19438/j.cjoms.2019.03.014
    Abstract ( 143 )   PDF (3071KB) ( 109 )  
    PURPOSE: To investigate the effect of atropine and different doses of penehyclidine hydrochloride on postoperative cognitive function in elderly patients undergoing oral and maxillofacial surgery. METHODS: One hundred and thirty-four elderly patients undergoing oral and maxillofacial surgery at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from December 2017 to July 2018 were included in the study. The patients randomly received atropine 0.5 mg (group A, n=32), penehyclidine hydrochloride 0.01 mg/kg (C1 group, n=34), penehyclidine hydrochloride 0.015 mg/kg (C2 group, n=33), normal saline (NS group, n=35) as preoperative medication. Preoperative anxiety scores, preoperative cognitive function scores, changes in vital signs after drug administration, degree of oral gland secretion, operation time, blood loss, recovery time, postoperative pain assessment, and postoperative cognitive function scores were compared between the four groups using SPSS18.0 software package. RESULTS: The changes of heart rate in group A was significantly higher than that in the other three groups (P<0.05). The number of oral secretions of patients in group A, C1 and C2 was significantly lower than that in the control group (P<0.05). The recovery time of C2 group was significantly longer than that of the other three groups (P<0.05), and the MMSE score was significantly decreased (P<0.05). CONCLUSIONS: Low dose (0.01 mg/kg) of penehyclidine hydrochloride before anesthesia induction does not prolong the recovery time, increase the risk of postoperative cognitive decline. At the same time, 0.01 mg/kg penehyclidine hydrochloride inhibits the secretion of salivary gland, and has little effect on cardiopulmonary system in elderly patients undergoing oral and maxillofacial surgery.
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    Anesthetic management of children with temporomandibular joint ankylosis and restricted mouth opening
    TANG Yong-hong, YAN Jia, HUANG Hui-min, XU Hui
    2019, 17 (3):  265-268.  doi: 10.19438/j.cjoms.2019.03.015
    Abstract ( 232 )   PDF (3130KB) ( 170 )  
    PURPOSE: To investigate anesthetic and difficult airway management in children with temporomandibular joint (TMJ) ankylosis. METHODS: Forty-three children with TMJ ankylosis and difficult airway were analyzed retrospectively . In case of spontaneous breathing, they were divided into ketamine group (K1 group) and Ketamine combined with dexmedetomidine group (K2 group). The dose of ketamine administration was 1~2 mg/kg intravenously in K1 group. In K2 group, 1 μg/kg dexmedetomidine was intravenously injected after ketamine administration.After the patients' consciousness disappearing, they were treated with intratracheal and laryngopharyngeal surface anesthesia, and intubated with fibrobronchoscopic nasal intubation. During intubation, the depth of anesthesia was maintained by adding titration of small dose of ketamine. GraphPad Prism 6.0 software was used to analyze the data. RESULTS: The children in both groups were successfully intubated through fibrobronchoscopic nasal intubation. During intubation, respiratory incidence (oxygen saturation<95%) rates in K2 group was a little lower than that in K1 group, but the difference was not significant (P>0.05). During intubation, the times of ketamine supplement in K2 group was significantly lower than that in K1 group, total ketamine dosage in K2 group was significantly lower than that in K1 group, and heart rate variation in K2 group was significantly lower than that in K1 group during intubation (P<0.05). CONCLUSIONS: Ketamine anesthesia combined with sufficient intratracheal and laryngopharyngeal surface anesthesia can accomplish the difficult airway fibrobronchoscope intubation in children with TMJ ankylosis, and ketamine combined with dexmedetomidine can make the intubation process of children's difficult airway shorter and more stable.
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    Clinical retrospective analysis of 200 cases with cystic lesions of the jaw bone
    FAN Yong-jing, JIN Wu-long, LIU Ying
    2019, 17 (3):  269-274.  doi: 10.19438/j.cjoms.2019.03.016
    Abstract ( 270 )   PDF (4957KB) ( 150 )  
    PURPOSE: To retrospectively analyze the composition and treatment of cystic lesions of jaw bone, to explore the clinical characteristics of cystic lesions of jaw bone, and compare the efficacy and prognosis of different treatment methods, so as to provide basis for improving diagnosis and treatment. METHODS: From January 2009 to September 2015, a total of 200 patients with cystic lesions of jaw bone treated in the Department of Oral and Maxillofacial Surgery in the Affiliated Hospital of Inner Mongolia Medical University were collected. SPSS 16.0 software package was used to compare the effects of different treatment methods. RESULTS: The proportion of apical cysts accounted for the most, the number of male patients was more than that of female patients, and the peak incidence was from 41 to 50 years; the lesions were formed more frequently in the maxilla than in the mandible, more in the left than in the right; patients with toothache and swelling pain in jaw bone accounted the most. Curettage was superior to decompression in the treatment of medium-sized cystic lesions, and decompression was superior to curettage in the treatment of large cystic lesions, the difference between different treatment modalities was statistically significant (P<0.05). The recurrence rate of odontogenic keratocyst and ameloblastoma treated by curettage was higher than that treated by decompression, but the difference was not significant (P>0.05). CONCLUSIONS: Curettage for small and medium-sized cystic lesions of jaw bone is effective and can shorten the healing time, while decompression for large cystic lesions is effective and beneficial to preserve adjacent tissue structure. Decompression and curettage can be used for the treatment of multicystic lesions of jaw bone.
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    Clinical Reports
    Application of posterior tibial artery flap in the reconstruction of oral and maxillofacial defects: Clinical analysis of 80 consecutive cases
    MAI Lian-xi, Mubarak Mashrah, YAN Ling-jian, WAN Quan, LIN Zhao-yu, PAN Chao-bin
    2019, 17 (3):  275-279.  doi: 10.19438/j.cjoms.2019.03.017
    Abstract ( 183 )   PDF (4191KB) ( 79 )  
    PURPOSE: To explore the efficacy and design of posterior tibial artery flaps (PTAF) in the reconstruction of oral and maxillofacial defects. METHODS: Between November 2017 and August 2018, 80 patients underwent reconstruction of oral and maxillofacial defects with posterior tibial artery flaps. All of them received preoperative examinations with computed tomography angiography (CTA) to identify the course and perforators of the posterior tibial artery. During surgery, the designed and dissected PTAF was transferred to the recipient site and filled the defects. Data including the thickness and the size of the flap, length and diameter of the artery, number and length of perforators, survival rate of the flaps, complications at both the donor and recipient sites were collected and analyzed. RESULTS: Of 80 patients, 56 were male and 24 were female, ranging in age from 24-90(58.17±1.43) years. The flaps measured from 5 cm×6 cm to 7 cm×13 cm, the thickness of the flap was 0.30-1.00(0.53±0.2) cm, the pedicle length of the PTAF was 8-14(10.03±1.4) cm. The caliber of the posterior tibial artery was 1.50-3.00(2.36±0.4) mm, the caliber of the posterior tibial vein was 1.50-4.0(2.99±0.6) mm. The number of the septocutaneous perforator was 1-5(2.61±0.9) per leg, mostly clustered in the middle and distal thirds of the middle surface of the leg. The length of the perforators was 0.3-6(1.70±0.7)cm. All PTAF survived well. Skin graft was required in all cases for donor site of PTAF. Total loss of the skin graft occurred in 2/80 (2.5%) of the patients. Partial loss of the skin graft occurred in 7/80 (8.7%) of the patients, but all healed by conservative treatment. CONCLUTIONS: It's an ideal choice to reconstruct oral and maxillofacial defect with PTAF. Also, caring the adipofascial extension is a better way to plump the form of the tongue, fill up the defect of the mouth floor and protect the vascular anastomosis from outer irritation.
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    Treatment experiences of 56 oral cancer cases with systemic diseases
    GAO Ce, YANG Xiao-chen, XU Hao-yue, GE Sheng-you, FENG Yuan-yong, BU Ling-xue, JIA Mu-yun, WANG Shuang-yi, CHEN Hong-hua, LU Hai-jun, SONG Kai, SHANG Wei
    2019, 17 (3):  280-284.  doi: 10.19438/j.cjoms.2019.03.018
    Abstract ( 206 )   PDF (3726KB) ( 107 )  
    PURPOSE: To summarize the experience of diagnosis and treatment of 56 oral cancer patients with systemic diseases. METHODS: The clinical data of 56 oral cancer patients with systemic diseases who were diagnosed and treated by Affiliated Hospital of Qingdao University were retrospectively reviewed. According to the features of oral cancer, the main therapy of primary tumor and systemic diseases were analyzed. RESULTS: In 56 patients, the treatment modalities for primary tumors included surgery, radiotherapy, chemotherapy, immunotherapy. Cardiovascular treatment was recommended for 34 patients (60.71%) with hypertension, 11 patients (19.64%) with coronary heart disease, 1 patient (1.79%) with severe arrhythmia. Twenty-three (41.07%) patients with diabetes mellitus were given reasonable blood sugar control protocol. Nineteen (33.93%) patients with respiratory diseases were given corresponding lung function test and treatment of complications after surgery. CONCLUSIONS: Multidisciplinary team approach is reasonable and effective for the diagnosis and therapy of oral cancer patients with systemic diseases, and it is worth of clinical application.
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    Retrospective analysis of 5762 out-patients with maxillofacial trauma
    SHI Xiao-yu, MA Hui-ying, ZHANG Ai-hua, WU Zhi-qiang
    2019, 17 (3):  285-288.  doi: 10.19438/j.cjoms.2019.03.019
    Abstract ( 143 )   PDF (2561KB) ( 157 )  
    PURPOSE: To investigate the epidemiological characteristics of out-patients with maxillofacial trauma and provide reference for prevention and treatment of maxillofacial trauma. METHODS: An epidemiological analysis was carried out among 5762 out-patients with maxillofacial trauma who were admitted to Shengjing Hospital Affiliated to China Medical University from January 2014 to December 2017. RESULTS: Male patients were more than female, and the ratio of male to female was 1.736:1. The peak age of trauma was 3-6 years (28.55%), followed by 0-3 years. Children aging 0-17 years accounted for 68.7% of the out-patients with maxillofacial trauma. Fall injury (72.9%) was the main cause of injury, followed by traffic accident (9.2%) and violence (7.5%). The third quarter (30.1%) was the peak of incidence. Forehead (37.24%) was the most common site of soft tissue injury, followed by cheek (19.04%) and lip (18.67%). CONCLUSIONS: Male patients were most frequently seen in out-patients with maxillofacial trauma, and the peak age was 3-6 years old. Falls and forehead are the most common causes of injury and site of injury.
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