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20 January 2021, Volume 19 Issue 1 Previous Issue    Next Issue

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Clinical Guidelines

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Clinical application of Tent-Peg technique in the reparation and regeneration of alveolar bone-standard operational practice ZOU Duo-hong, LIU Chang-kui, XUE Yang, HU Kai-jin, YANG Chi, ZHNAG Zhi-yuan 2021, 19 (1):  1-5.  doi: 10.19438/j.cjoms.2021.01.001 Abstract ( 2029 )   PDF (3998KB) ( 1351 )   ] Alveolar bone is the foundation of dentology. The reparation and regeneration of alveolar bone defects have strong relationship with sub-disciplines including implant dentistry, orthodontics, periodontology and prosthodontics. Therefore, the effective methods of repairing and reconstructing alveolar bone have important clinical significance and great social benefits. With the development of guide bone regeneration (GBR) technique and advent of alveolar bone regeneration based on stability centered concept, an entirely new bone augmentation approach based on Tent-Peg technique developed rapidly and was validated in clinical practices. The technique is characterized by low technique sensitivity, simple operation procedure, short operation time and low costs. Furthermore, alveolar bone regeneration based on this technique can be achieved with just artificial biomaterials instead of autogenous bone grafts. In conjunction with its advantages, Tent-Peg technique is increasingly favored and valued by patients and clinicians. However, clinicians still face many difficulties achieving effectively clinical application of this technique, including standard operation practice, right position of the Tent-Peg, proper orientation of the pegs and right order of placing GBR membrane and Tent-Peg. Our team established standard operation practice of Tent-Peg technique for alveolar bone regeneration based on clinical practice. We hope that this article will provide a reference and basis for clinicians when applying this technique for alveolar bone regeneration, popularize the clinical application of this technique and finally offer practical help to patients suffering from alveolar bone defects. References | Related Articles | Metrics

Original Articles

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Effects of oyster protein peptide with different concentrations on the proliferation and differentiation of bone marrow mesenchymal stem cells WANG Yi-wei, LI Chen-lin, JIANG Qian, XU Guang-zhou 2021, 19 (1):  6-11.  doi: 10.19438/j.cjoms.2021.01.002 Abstract ( 299 )   PDF (4545KB) ( 251 )   PURPOSE: To investigate the effect of different concentrations of oyster protein peptide on osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). METHODS: BMSCs of the third generation from rats with stable subculture ability were selected, and the cell viability was detected by MTT kit at different concentrations of 0, 10, 20 and 50 mg/L oyster protein peptide for 24 hours, 3 days and 7 days. BMSCs were divided into two groups: cultured with DMEM or ODM. According to the different concentrations of oyster protein peptide, the experimental groups were divided into four subgroups, which were 0, 10, 20 and 50 mg/L, respectively. The effects of different concentrations of oyster protein peptide on the early osteogenic differentiation of BMSCs were evaluated by ALP staining and ALP semi-quantitative detection. Alizarin red staining was used to detect the effect of different concentrations of oyster protein peptide on the osteogenesis and mineralization of BMSCs after 21 days of treatment. RT-PCR was used to defect the expression of bone formation-related genes. SPSS 20.0 software package was used to analyze the data. RESULTS: The results of MTT showed that cell activity was vigorous and there was no obvious abnormality after intervention with different concentrations of drugs, but the number of cell death increased when the concentration of oyster protein peptide was 50 mg/L. The results of ALP semi-quantitative analysis showed that ALP activity of DMEM and ODM group was significantly higher than that of the control group (P<0.05) on the 10th day of differentiation induction, but there was no significant difference between 50 mg/L group and the control group. Alizarin red semi-quantitative analysis showed that the A value of 20 mg/L in ODM group was significantly higher than that of the control group(P<0.05). The expression of RUNX-2 and OCN in 10 mg/L and 20 mg/L groups were significantly higher than that in control goup and 50 mg/L group(P<0.05). CONCLUSIONS: Oyster protein peptide with a concentration higher than 50 mg/L can significantly inhibit osteogenic differentiation of BMSCs, while oyster protein peptide with a low concentration, especially oyster protein peptide with a concentration of 20 mg/L, can promote osteogenic differentiation and cell growth of BMSCs. References | Related Articles | Metrics

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Changes of swallowing function in 40 patients with tongue squamous cell carcinoma after simultaneous reconstruction: a longitudinal study HE Xing-fang, LIN Yan-tong, WANG Shuai, YE Jing-jing, LIU Jie, HUANG Qiu-yu 2021, 19 (1):  12-17.  doi: 10.19438/j.cjoms.2021.01.003 Abstract ( 642 )   PDF (4136KB) ( 159 )   PURPOSE: To investigate the changes of swallowing function in 40 patients with tongue squamous cell carcinoma undergoing radical resection and simultaneous repair and reconstruction 1 year after operation, to find the best swallowing rehabilitation opportunity for patients, and to provide targeted swallowing function guidance for patients. METHODS: The swallowing function of 40 cases of tongue squamous cell carcinoma undergoing simultaneous reconstructive surgery before (S0), 7 days to 10 days (S1), 3 months (S2), 6 months (S3), and 12 months (S4) after surgery were tested by the special evaluation method of swallowing function such as water swallowing test (WST) and the functional oral intake scale (FOIS). The data were analyzed using GraphPad Prism 5.0 software packages. RESULTS: Postoperative deglutition and feeding function were poor, especially in stage S1, which decreased significantly, and in stage S2 and S3, which accumulated gradually. Except for some patients, stage S4 patients returned to the preoperative state. WST results showed that there wasn't significant difference in swallowing function between stage S3, S4 patients and stage S0 patients (P>0.05). FOIS results showed that there was no significant difference in feeding function between S4 stage patients and S0 stage patients (P>0.05). The recovery of the feeding function was 6 months later than that of the swallowing function. The recovery of swallowing and feeding ability of patients with T4 tumor was worse than that of patients with T2 and T3 in stage S4, and the difference was statistically significant(P<0.05). The recovery of feeding ability in stage S4 patients was better in patients without tongue root deficiency than those with tongue root deficiency, and the difference was statistically significant(P<0.05). Postoperatively, patients without radiotherapy or chemotherapy had a better recovery of feeding function in S4 than those with radiotherapy or chemotherapy, and the difference was statistically significant(P<0.05). CONCLUSIONS: Some patients had mild dysphagia before operation, and 3 to 6 months after operation is the best time for patients to recover their swallowing function. It is important to strengthen health education and swallowing rehabilitation training of T4 patients and patients with loss of tongue, radiotherapy, and chemotherapy. References | Related Articles | Metrics

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Influence of wound healing with or without wound suture after extraction of mandibular impacted teeth DING Zuo-you, ZHU Guang-lai, XIU Li-jun 2021, 19 (1):  18-21.  doi: 10.19438/j.cjoms.2021.01.004 Abstract ( 656 )   PDF (2903KB) ( 570 )   PURPOSE: To investigate the effect of different healing modes of modified angle flap on recovery and safety of impacted teeth extraction. METHODS: One hundred and ninety-three patients with unilaterally impacted mandibular molar extraction were enrolled, and randomly divided into two groups: wound suture group and non-suture group. All teeth were extracted with the same methods. After extraction, the wound of suture group underwent triangular flap-primary healing (TF-P), while modified triangular flap-secondary healing (MTF-S) was achieved on a triangular region of mucosa posterior to the lower second molar in the non-suture group. The pain (VAS) score, swelling degree, trismus, healing time, postoperative complications, probing depth (PD) and clinical attachment loss (CAL) of the second molar were compared between the two groups. SPSS 20.0 software package was used for data analysis. RESULTS: VAS score of non-suture group was significantly lower than that of suture group at 1 d and 3 d postoperatively (P<0.05). Swelling degree and trismus of non-suture group were significantly milder than those of suture group at 1, 3 and 7 d postoperatively (P<0.05). The incision healing time of non-suture group was significantly longer than that of the suture group (P<0.05). The incidence of trismus and swelling in non-suture group was significantly lower than that in the suture group (P<0.05). The incidence of dry socket, pain and incision infection in non-suture group was slightly lower than that in the suture group, but with no significant difference (P>0.05). CONCLUSIONS: Modified triangular flap-secondary healing for patients with unilaterally impacted mandibular molar extraction can effectively ameliorate the pain degree, swelling, and trismus, which is worthy of clinical promotion. References | Related Articles | Metrics

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Correlation analysis of imaging features and clinicopathological features in 53 cases of first branchial cleft cyst ZHU Dan, CHEN Pei-qian, SUN Jing-jing, TAO Xiao-feng, ZHU Ling 2021, 19 (1):  22-28.  doi: 10.19438/j.cjoms.2021.01.005 Abstract ( 428 )   PDF (5489KB) ( 338 )   PURPOSE: To analyze the correlation between imaging characteristics of the first branchial cleft cyst (FBCC) and different pathological types, and to analyze the different clinical treatment methods of each pathological type. METHODS: A retrospective study was conducted for FBCC patients who were confirmed by surgery and postoperative pathology in Shanghai Ninth Peoples' Hospital from January 2013 to December 2019. All the patients underwent CT and MRI examinations before surgery. The clinical, pathological, imaging and prognostic data were statistically analyzed using SPSS 26.0 software package. RESULTS: All 53 cases were confirmed by surgical pathology. Forty-nine cases (49/53, 92.5%) were located in the parotid gland areas, and 4 cases (4/53, 7.5%) were located below the submandibular angle and above the hyoid bone. TypeⅠ was in 45 cases and type Ⅱ was in 8 cases. Obvious infection was seen in 7 cases (typeⅠ: 3 cases, type Ⅱ: 4 cases), sinus/fistula in 6 cases (typeⅠ: 2 cases, type Ⅱ: 4 cases). Forty-nine patients underwent tumor resection, and 4 patients underwent expanded tumor resection. The median follow-up time was (41.52±24.59) months. Six patients (6/53, 11.3%) recurred after operation. The patient's age (≤10 years old), cysts with fistula/sinus, deep location deep to the facial nerve and history of incision and drainage had significant differences on recurrence(P<0.05). FBCCs were mostly located between facial nerve branches (32/53, 60.4%), and most of them had clear boundary (48/53, 90.6%). Type Ⅰ and Ⅱ had significant differences in morphology, CT value, density/signal (P<0.05). Thin-slice CT combined with multiplanner reformation (MPR) technique showed 6 cases (6/6, 100%) of FBCC with fistula/sinus tracts, the lengths were 1.5-3 mm and tube diameters were 0.7-1.5 mm, without obvious fistula/sinus tract on MRI. CONCLUSIONS: FBCC with different clinicopathological features has different imaging features, and thin-slice CT combined with MPR reconstruction technology can better display the accompanied sinus/fistula, which play an important guiding role in clinical diagnosis , treatment and prevention of recurrence. References | Related Articles | Metrics

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Effects of region of interest sizes on apparent diffusion coefficient measurements of pleomorphic adenoma, Warthin tumor, and normal parotid parenchyma SUN Qi, MA Chao, DONG Min-jun, TAO Xiao-feng 2021, 19 (1):  29-35.  doi: 10.19438/j.cjoms.2021.01.006 Abstract ( 242 )   PDF (5651KB) ( 125 )   PURPOSE: Tumor apparent diffusion coefficient (ADC) measurements may be influenced by region of interest (ROI) sizes; however, this effect has not been systematically studied in parotid tumors. The purpose of this study was to determine the effects of ROI size on ADC measurements for differentiation of pleomorphic adenoma (PA), Warthin tumor (WT), and normal parotid parenchyma. METHODS: Sixty-five patients including 37 with PA (lesions, n=37) and 28 with WT (lesions, n=37) were examined with diffusion-weighted imaging (DWI). Participants with normal contralateral parenchyma of the parotid gland comprised the control group (n=56). The mean ADC values and standard deviations (SD) of the ADC (ADCSD) of 12 concentric round ROIs (areas: 9, 28, 34, 50, 60, 82, 93, 98, 115, 130, 136, and 149 mm2) for tumors and normal tissue were measured by using custom-made software. Homogeneity index that was defined by the ADCSD/mean ADC was also calculated. One-way repeated analyses of variance (ANOVA) was performed on the mean ADCs, ADCSD and homogeneity indices of the 12 ROIs in each group. The three parameters at different ROIs among PA, WT and normal parotid parenchyma were compared using Kruska-Wallis tests with Medcalc software. RESULTS: Excellent agreement was achieved for ADC measurements with 12 ROIs for PA (ICC, 0.98), WT (ICC, 0.99) or normal parotid parenchyma (ICC, 0.95). No significant difference was observed in the mean ADCs of 12 ROIs for each of the three groups (P>0.05). Among the three groups, the mean ADC of normal parotid parenchyma[(0.94±0.003) ×10-3 mm2/s] was significantly lower than that of both PA [(1.72±0.01)×10-3 mm2/s] and WT [(1.16±0.01)×10-3 mm2/s] in 12 ROIs, whereas PA group had the highest mean ADC values. No significant difference was found in the mean ADCSD with each ROI between PA and WT (P>0.017). PAs had significantly lower homogeneity indices compared with WTs and normal parotid parenchyma(P<0.01). CONCLUSIONS: The effect of ROI size on ADC measurements could be excluded from the differentiation of PA, WT, and normal parotid parenchyma. Homogeneity index was a useful parameter in discriminating the three groups. References | Related Articles | Metrics

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The difference of MRI signal intensity between condyle and brain parenchyma in cases of temporomandibular joint disc displacement WAN Shao-nan, YIN Zhi-guo, XIE Qian-yang, LIU Zhi-yang, DONG Min-jun, SUN Qi, YANG Chi 2021, 19 (1):  36-39.  doi: 10.19438/j.cjoms.2021.01.007 Abstract ( 396 )   PDF (2986KB) ( 232 )   PURPOSE: To compare the difference of signal density ratio between condyle and brain parenchyma in normal temporomandibular joint (TMJ) structure and patients with anterior disc displacement and condylar absorption, and to explore the quantitative measurement method of condylar absorption. METHODS: From July 2018 to July 2019, 22-25 year-old women who underwent MRI examination of TMJ were collected and divided into two groups: normal joint group and condylar absorption group. A total of 40 joints in the 2 groups were measured independently by 2 investigators, and the consistency between the 2 measurers was compared. The differences of MSI1/MSI2 between the 2 groups were compared. SPSS 23.0 software package was used for statistical analysis. RESULTS: There was a high degree of consistency from the 2 investigators. At the same time, there was significant difference between the 2 groups in the ratio of condylar signal density to brain parenchyma. The mean value of MSI1/MSI2 was 1.07 in normal joint group, and 0.78 in condylar resorption group(P<0.05). CONCLUSIONS: MSI1/MSI2 may be an objective index to evaluate the severity of condylar lesions by using standardized TMJ MRI shooting process. References | Related Articles | Metrics

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Use of pentazocine to prevent agitation in children with cleft palate surgery during the recovery period of general anesthesia ZHANG Ling, QIU Lin, JI Jun 2021, 19 (1):  40-44.  doi: 10.19438/j.cjoms.2021.01.008 Abstract ( 310 )   PDF (3890KB) ( 177 )   PURPOSE: To investigate the effect and safety of pentazocine to relieve the emergence agitation on children, who received cleft palate surgery during the recovery period of general anesthesia. METHODS: Sixty children, ASA I~II,aged 1-3 years old who received cleft palate surgery, were randomly divided into 3 groups(n=20): group P1, group P2 and group NS. When entering the post-anesthetic care unit (PACU), the children were intravenously injected of pentazocine: 0.5 mg/kg (P1), 0.3 mg/kg (P2) and 0.9% NaCl (NS), respectively. Coughing score, Ramsay sedation score, pediatric anesthesia emergence delirium (PAED) and modified children's hospital of eastern ontario pain scale (m-CHEOPS) of the 3 groups were compared. Changes of HR, MBP, RR, SPO2 at each time point and the incidence of adverse events were observed and recorded. SPSS 19.0 software package was used for data processing. RESULTS: During the recovery period of general anesthesia, the Ramsay sedation score of group P1 and P2 was significantly higher than group NS(P<0.05) ; cough score of group P1 and P2 was significantly lower than group NS(P<0.05); PAED score and m-CHEOPS score of group P1 was significantly lower than group NS(P<0.01); group P2 was lower than group NS, but the difference was not significant(P>0.05). There was no significant difference in recovery time and the adverse reaction between the 3 groups (P>0.05). CONCLUSIONS: Injection of pentazocine after operation can effectively reduce the incidence of agitation during the recovery period of general anesthesia in children who received cleft palate surgery, and the children in the recovery period are more stable and safer, the recommended dose of pentazocine is 0.5 mg/kg. References | Related Articles | Metrics

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Analysis of anesthetic effect of remifentanil combined with ketamine in cleft lip and palate surgery in infants LIN Xiao-rui, LI Chen-xi, ZHANG Xiu-hua 2021, 19 (1):  45-48.  doi: 10.19438/j.cjoms.2021.01.009 Abstract ( 255 )   PDF (3371KB) ( 181 )   PURPOSE: To observe and analyze the anesthetic effect of remifentanil combined with ketamine in cleft lip and palate surgery of infants. METHODS: Ninety-six infants who underwent repair of congenital cleft lip and palate in our hospital from December 2017 to December 2019 were selected, the children were randomly divided into an experimental group (n=48) and a control group (n=48) according to the order of admission. Patients in the control group were anesthetized with ketamine alone, while patients in the experimental group were anesthetized by remifentanil combined with ketamine. The blood pressure, heart rate, and anesthesia recovery time were used to evaluate the anesthetic effect of the two groups of children and the amount of applied ketamine was recorded. SPSS 22.0 software package was performed for statistical analysis. RESULTS: There was no significant difference in the respiration and blood oxygen saturation between the two groups of children during and after surgery (P>0.05). There was no significant difference in heart rate and mean arterial pressure between the two groups of children before operation. The heart rate and mean arterial pressure of the children in the experimental group were significantly lower than those in the control group during and after surgery (P<0.05). The anesthesia wake-up time of the experimental group was significantly shorter than that of the control group, and the amount of applied ketamine was significantly lower than that of the control group. The incidence of respiratory depression, increased airway secretion, and agitation was significantly lower than that of the control group(P<0.05). There was no significant difference in the incidence of adverse reactions such as vomiting, laryngeal spasm, asphyxia and fever between the two groups of children (P>0.05). CONCLUSIONS: Remifentanil combined with ketamine as an anesthetic for cleft lip and palate repair in infants and young children could improve blood pressure, heart rate, shorten anesthesia recovery time, reduce respiratory depression and decrease airway secretions while maintaining stable blood oxygen saturation. Moreover, its analgesic effect is exact and the safety is high. References | Related Articles | Metrics

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Evaluation of the effect of music therapy on sedation and analgesia in 90 patients with endotracheal intubation after orthognathic surgery XIN Zhi-xiang, SUN Lu-lu, LIN Yu, LYU Xiang 2021, 19 (1):  49-51.  doi: 10.19438/j.cjoms.2021.01.010 Abstract ( 379 )   PDF (2522KB) ( 242 )   PURPOSE: To investigate the efficacy and safety of music therapy in sedation and analgesia of patients with endotracheal intubation after orthognathic surgery. METHODS: Ninety patients undergoing orthognathic surgery were randomly divided into 3 groups, 30 in each group. Patients in groups A and B received treatment of sedation and analgesia with dexmedetomidine at 0.4 μg/(kg·h) and 0.8 μg/(kg·h), respectively; while patients in group C were given dexmedetomidine with 0.4 μg/(kg·h) + music therapy. The general conditions were recorded and average blood pressure, heart rate, sedation and analgesia scores at 3 h(T1), 6 h(T2), 9 h(T3) and 12 h(T4) in ICU after operations were also observed. The incidence of adverse reactions was compared among the 3 groups. The data were analyzed using GraphPad Prism 5 software package. RESULTS: The mean blood pressure of group A and group C was significantly higher than that of group B at T2, T3 and T4 time points, the heart rate of patients in group A and group C was significantly higher than that of patients in group B at each time point (P<0.05). Ramsay sedation score of patients in group B and group C was significantly higher than that of group A at all time points, while VAS pain score was significantly lower than that of group A (P<0.05). The incidence of bradycardia and hypotension in group C was significantly lower than that in group B (P<0.05). CONCLUSIONS: Music therapy can reduce the use of dexmedetomidine in patients with endotracheal intubation after orthognathic surgery. It has definite effect of assistant sedation and analgesia, and can reduce the incidence of adverse drug reactions. References | Related Articles | Metrics

Clinical Reports

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Clinical and prognostic analysis of Langerhans cell histiocytosis in oral maxillofacial head and neck: report of 36 consecutive cases YANG Ran-ran, JU Hou-yu, REN Guo-xin, GUO Wei 2021, 19 (1):  52-58.  doi: 10.19438/j.cjoms.2021.01.011 Abstract ( 795 )   PDF (5157KB) ( 275 )   PURPOSE: This retrospective study was performed to analyze and discuss the clinical characteristics, diagnosis, treatment and prognosis of Langerhans cell histiocytosis(LCH) in oral maxillofacial head and neck region, in order to provide evidence-based evidence for clinical treatment. METHODS: The clinical data of 36 cases of LCH of adults and children treated in the Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital were retrospectively analyzed. The prognosis of LCH was analyzed by SPSS 22.0 software package. RESULTS: The median age of 36 LCH patients was 31 years (8 months to 74 years). The main clinical manifestations were oral mucosal ulcer or granuloma, accompanied by pain and swelling; craniomaxillofacial bone damage was chisel like destruction; gingival necrosis, tooth displacement, tooth loss and alveolar bone destruction. 22% patients had history of diabetes insipidus. According to the scoring standard of Lavin osband, 26 cases were classified as grade Ⅰ, 9 as grade Ⅱ, 1 as grade Ⅲ and 0 as grade Ⅳ. The most common sites were jaw, gum and palate. Twenty-three patients received single treatment, 13 patients received combined treatment. The median follow-up time was 22.5 months, 1 patient was lost to follow-up, 1 patient died. The complete remission rate was 75% after initial treatment. The 5-year relapse free survival rate was 53.78%; 20 patients received systemic therapy; 17 patients had single system involvement, 19 patients had multiple systems involvement, 24 patients underwent detection of BRAF-V600E mutation, 6 patients were positive, and 1 patient took targeted drug orally and the effect was significant. CONCLUSIONS: ① The initial treatment of oral and maxillofacial head and neck Langerhans cell histiocytosis is good, the ultimate goal of the treatment is to treat the disease and prolong the time of recurrence. ② Treatment has significant impacts on the overall survival of patients. Chemotherapy can prolong the survival time of patients without recurrence. After pathological diagnosis, it is suggested that the treatment should be determined according to the involvement of organ system after PET-CT evaluation of systemic condition. ③ For patients whose first-line and second-line responses are not obvious, detecting BRAF-V600E gene mutations and choosing targeted drug therapy according to the results. References | Related Articles | Metrics

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Clinical characteristics and treatment of bisphosphonate jaw osteomyelitis in different clinical stages: a report of 16 consecutive cases GUO Yan-hong, YESIHATI·Muhetaer, LI Hong, SUN Yang, GONG Zhong-cheng 2021, 19 (1):  59-63.  doi: 10.19438/j.cjoms.2021.01.012 Abstract ( 453 )   PDF (3743KB) ( 257 )   PURPOSE: The clinical characteristics and relevant examinations of bisphosphonate related osteonecrosis of the jaw（BRONJ）were analyzed in order to provide a basis for clinical prevention. METHODS: Retrospective analysis of 16 patients diagnosed with BRONJ in the First Affiliated Hospital of Xinjiang Medical University and Xinjiang Uygur Autonomous Region People's Hospital from 2013 to 2019, including general data, laboratory and imaging examination was performed. SPSS 24.0 software package was used for statistical analysis of the data. RESULTS: Among 16 patients, there were 6 males (37.5%) and 10 females(62.5%). There were primary tumors in 15 patients and osteoporosis in 1 patient. Among them, 4(25%) patients used bisphosphonates (BPs) for less than twelve months, 8(50%) patients for 12-36 months, and 4(25%) patients used bisphosphonates (BPs) for more than or equal to 36 months. Sixteen patients were at stage Ⅱ or Ⅲ. There was a significant difference between the time of using BPs and BRONJ stages(P<0.05). There was no significant difference between the time to visit for clinical symptoms after using BPs and the stage of BROBJ, and the time between the use of BPs and the laboratory test results(P>0.05). Bone mineral density measurement showed that bone density of BPs group in both regions was significantly higher than suppurative jaw osteomyelitis group and the healthy controls(P<0.05). There was no significant difference in bone mineral density between healthy group and suppurative jaw osteomyelitis group (P>0.05). CONCLUSIONS: The results suggest that the longer the time of using BPs, the more severe the BRONJ infection. Bone mineral density increased significantly after the use of BPs, and osteonecrosis of jaw bone was more likely to occur. References | Related Articles | Metrics

Evidence-Based Dentistry

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Effect of surgical therapy for patients with cranio-maxillo-facial fibrous dysplasia on visual acuity: a systematic review LUO Dan, LI Chen-xi, GONG Zhong-cheng 2021, 19 (1):  64-69.  doi: 10.19438/j.cjoms.2021.01.013 Abstract ( 230 )   PDF (4691KB) ( 127 )   PURPOSE: To investigate the clinical effect and safety of surgical operation for patients who suffered from cranio-maxillo-facial fibrous dysplasia (CFD) on the aspect of visual acuity. METHODS: PubMed, Web of Science, Cochrane Library, Cochrane Clinical Trials Registration Center, CNKI, Wanfang database and VIP database were searched respectively and successively by computer up to now. All the patients who suffered from CFD were included, and the ones without visual impairment were defined as the experimental group, the other ones who got visual damage were defined as the control group. The total number of patients with visual impairment because of therapeutic surgery was extracted, and the data were processed in the way of meta-analysis. RESULTS: Fixed effect model was used for meta-analysis because there was good homogeneity between the studies (Chi2=8.63, df=9, P=0.47, I2=0%). Patients who had not visual impairment accepted surgery for their CFD as treatments and surgery did not increase the incidence of visual impairment[OR=0.39,95%CI(0.18-0.86),P=0.02]. There was no publication bias among the studies as well. CONCLUSIONS: Applying surgical operation for the treatment of CFD may not increase the possibility of visual impairment. References | Related Articles | Metrics

Review Articles

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The effect of cancer-associated fibroblast in glucose metabolism of tumor cells LI Ming-yu, MA Hai-long, YANG Xi, ZHANG Zhi-yuan 2021, 19 (1):  70-75.  doi: 10.19438/j.cjoms.2021.01.014 Abstract ( 349 )   PDF (5207KB) ( 220 )   ] Warburg effect described a phenomenon that tumor cells undergoing aerobic glycolysis even with enough oxygen, generating lactic acid and little ATP. Although it had a low efficiency of energy production, lactic acid and other products may work as intermediates to modify tumor microenvironment and promote tumor progression. Recently, it's reported that fibroblasts, an important part of tumor stroma, were endowed with cancer-associated fibroblast (CAF) phenotype such as undergoing aerobic glycolysis, mitophagy and mitochondrial dysfunction. CAF provided lactic acid and other intermediates as building blocks for macromolecule anabolism, which could facilitate tumor proliferation, invasion, metastasis and drug resistance. On the contrary, tumor cells obtained activated oxidative phosphorylation and mitochondrial metabolism, which was named as "reverse Warburg effect". The two theory unveiled a metabolic flexibility and cross-talk among tumor cells and acidic tumor microenvironment, which facilitates tumor progression. References | Related Articles | Metrics

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A retrospective analysis of sleep breathing disordered after pharyngoplasty for velopharyngeal insufficiency secondary to cleft palate ZHAO Xin-ran, CAI Ming 2021, 19 (1):  76-81.  doi: 10.19438/j.cjoms.2021.01.015 Abstract ( 378 )   PDF (5083KB) ( 167 )   ] The commonly used surgical methods for velopharyngeal insufficiency secondary to cleft palate include pharyngeal flap, sphincter pharyngoplasty and Furlow palatoplasty (double-opposing Z-plasty). Polysomnography (PSG) combined with the chief complaints indicated that some patients who had underwent pharyngoplasty for velopharyngeal insufficiency would have different levels of obstructive sleep apnea-hypopnea syndrome (OSAHS). Some patients with mild symptoms could be relieved by themselves, while those with severe symptoms need to be treated by oxygen inhalation or continuous positive airway pressure(CPAP), and very few had to have the flap removed or loosened through another surgery. There was no significant difference in the morbidity of OSAHS between children and adults, but the condition of children was more serious than that of adults. Patients with preoperative OSAHS might have their symptoms aggravated after surgery. In the short-term follow-up (≤6 months) of patients with different surgical procedures, the incidence of OSAHS was the lowest in Furlow palatoplasty, followed by sphincter pharyngoplasty, and the highest was posterior pharyngeal flap. However, long term follow-up (>12 months) demonstrated that there was no significant difference in the morbidity. At present, there is no unified operation for velopharyngeal insufficiency secondary to cleft palate, and the morbidity of OSAHS after various operation methods is still controversial. PSG should be applied as a routine examination during the perioperative period of pharyngoplasty, so as to evaluate the impact of different operation methods on sleep disordered breathing more accurately. References | Related Articles | Metrics

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Research progress of regulating endothelial cell related arteriovenous differentiation YOU Yuan-he, DU Zhong, LIU Jia-liang, ZHENG Jia-wei, WANG Yan-an 2021, 19 (1):  82-87.  doi: 10.19438/j.cjoms.2021.01.016 Abstract ( 236 )   PDF (4743KB) ( 153 )   ] Arteriovenous differentiation is a regulated programmatically biological process that involves multi-genetics and multi-factors. The regulation of differentiation of arteriovenous endothelial cells(EC) is one of the most critical prerequisites for this process. Hedgehog, VEGF, Notch, COUP-TF Ⅱand other vascular development-related signaling pathways participate in regulating the differentiation of endothelial cells. However, the expression levels and functions of above molecules in this process are variant. In addition, hemodynamic is also an indispensable factor for arteriovenous endothelial differentiation. This article reviewed progression of arteriovenous differentiation of vascular endothelial cell in recent years, from aspects of molecular markers, related signaling pathways, and hemodynamics of arteriovenous endothelial cells. References | Related Articles | Metrics

Case Reports

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Aglossia: report of one case ZHAI Cai-hong, JIANG Yin-hua 2021, 19 (1):  88-90.  doi: 10.19438/j.cjoms.2021.01.017 Abstract ( 404 )   PDF (1946KB) ( 285 )   ] Aglossia is a severe developmental disease caused by abnormal tongue development, which is extremely rare. This paper reported a case of aglossia. The etiology, clinical manifestation and related treatment were provided to help clinical diagnosis and treatment. References | Related Articles | Metrics

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Misdiagnosis of mucocele in buccal minor salivary glands: a case report GAO Qian-qian, SHANG Wei, LIU Xiao-hua 2021, 19 (1):  91-93.  doi: 10.19438/j.cjoms.2021.01.018 Abstract ( 674 )   PDF (1858KB) ( 392 )   ] Mucocele of minor salivary glands was common in the lower lip and rarely in the cheek. Buccal mucous cyst was usually located in the submucosal tissues between the buccinator muscle. As a mucocele, the clinical manifestation of buccal mucocele was not typical, and it was easy to be misdiagnosed in clinic. This paper reported a case of larger mucocele from buccal minor salivary glands which was misdiagnosed as lipoma, in order to provide references for the diagnosis and treatment of buccal masses. References | Related Articles | Metrics

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Unilateral parotid gland involvement with 2 different pathological tumors: a case report YUAN Xu-guang, ZHU Jun-fei, LI Tian-zhu, GUANG Meng-kai, ZHANG Ye 2021, 19 (1):  94-96.  doi: 10.19438/j.cjoms.2021.01.019 Abstract ( 555 )   PDF (1910KB) ( 228 )   ] Parotid gland tumor is one of the common tumors in the head and neck. Multiple primary tumors of the parotid gland are relatively rare in clinic, and cases with different pathological types in the same parotid gland are even more rare. This paper reported one case with basal cell adenoma and pleomorphic adenoma in the ipsilateral parotid gland, and reviewed the related literatures. References | Related Articles | Metrics