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20 March 2022, Volume 20 Issue 2 Previous Issue    Next Issue

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Effect of exosomes derived from human dental pulp stem cells on peripheral nerve regeneration after crush injury CHAI Ying, LIU Zhi-yang, LIU Yue-min, CHEN Min-jie, YANG Chi 2022, 20 (2):  105-110.  doi: 10.19438/j.cjoms.2022.02.001 Abstract ( 274 )   PDF (2446KB) ( 123 )   PURPOSE: To study the effect of exosomes derived from human dental pulp stem cells (hDPSCs) on recovery of peripheral nerve crush injury. METHODS: Thirty-six adult SD rats were randomly divided into two groups. Group A was treated with exosomes derived from hDPSCs after sciatic nerve injury, while group B was treated with PBS after sciatic nerve injury. The behavioral changes of rats were observed at 3, 7 and 14 d after injury. The nerve tracts were observed by H-E staining and immunohistochemical staining, and the changes of myelin sheath were observed by electron microscope. The data were analyzed by one-way ANOVA with SPSS 24.0 software package. RESULTS: Behavioral observation showed that the sciatic functional index(SFI) decreased in both groups after injury. With the time going on, the two groups basically recovered 2 weeks after injury, but the recovery in group A was faster than group B(P<0.05). H-E staining and immunohistochemical staining showed that after injury, nerve tract morphological damage and irregular perineurium appeared in both groups, but the degree of perineurium damage in group A was lighter than group B, and the recovery speed was faster. Electron microscopic observation showed that myelin disintegration, edema and degeneration occurred in both groups after injury, but the recovery speed of myelin in group A was faster than group B. CONCLUSIONS: Exosomes derived from hDPSCs can promote recovery of peripheral nerve injury, and its mechanism may be related to accelerating the regeneration of myelin sheath. References | Related Articles | Metrics

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Experimental study on inhibition of alveolar bone resorption around periodontitis in rats by cyclocreatine LI Hui-ping, LIU Xiu-ming, XU Wei-feng, ZHEN Jin-ze, SHEN Da, ZHANG Shan-yong 2022, 20 (2):  111-116.  doi: 10.19438/j.cjoms.2022.02.002 Abstract ( 278 )   PDF (1157KB) ( 91 )   PURPOSE: To evaluate the inhibitory effect of cyclocreatine on alveolar bone resorption caused by periodontitis both in vitro and in vivo. METHODS: In vitro, the effects of cyclocreatine on proliferation and differentiation of osteoblasts and osteoclasts were evaluated by cell viability assay, alkaline phosphatase staining (ALP) and alizarin red staining, tartrate resistant acid phosphatase (TRAP) staining and real-time reverse transcription PCR (RT-PCR). Twenty rats were divided into four groups, group A was as control group, group B with periodontal ligation + normal saline injection, group C with periodontal ligation + low concentration injection, group D with periodontal ligation + high concentration injection. Except the control group, all rats were ligated on bilateral maxillary first molars for 4 weeks, and then treated with local injection of cyclocreatine for 2 months. The maxilla was collected for further Micro-CT evaluation. SPSS 16.0 software package was used for statistical analysis of the data. RESULTS: In vitro, cyclocreatine inhibited the proliferation and differentiation of osteoclasts, but did not affect osteoblasts. In vivo, local application of cyclocreatine can prevent local alveolar bone loss and increase alveolar ridge height. CONCLUSIONS: Cyclocreatine can inhibit proliferation and differentiation of osteoclasts, inhibit formation of osteoclasts and reduce alveolar bone loss in rat with periodontitis. References | Related Articles | Metrics

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The effect of oral implant-abutment microgaps closed by sealing materials on implant-supported prosthesis, surrounding bone MA Jie, WANG Qi-shuai, ZHANG Bing-hua, CHEN Tian-tian, CAI Guo-ping, SONG Tao 2022, 20 (2):  117-122.  doi: 10.19438/j.cjoms.2022.02.003 Abstract ( 277 )   PDF (1504KB) ( 125 )   PURPOSE: To investigate the stress and stress distribution generated on each component of dental implant system and surrounding bone when using sealing materials to close the implant-abutment microgaps. METHODS: A finite element model of partial mandible without first molar was set up, and a dental implant (Straumann) was placed. The implant system models were established with different sizes of implant-abutment microgaps (5, 6, 7, 8, 9 μm), which were closed by sealing materials. The loading forces were 100 N axially (0°) and 100 N obliquely (45°) respectively on occlusive surface. Finite element analysis was performed by computer. RESULTS: The stress on the whole prosthesis and the abutment was almost unchanged whether the implant-abutment microgap was filled or not. When the microgap was closed, the equivalent stress on the implant decreased slightly, and the equivalent stress on the surrounding bone decreased significantly. The stress on the whole prosthesis increased with the increase of the microgaps. CONCLUSIONS: Using sealing materials to close the implant-abutment microgaps could effectively reduce the stress on the implant and mandible, which may have some practical value. References | Related Articles | Metrics

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Effect of shRNA interference Rce1gene expression on the radiosensitivity of oral squamous cell carcinoma cells SUN Da-wei, ZHANG Yun, ZHU Yong 2022, 20 (2):  123-128.  doi: 10.19438/j.cjoms.2022.02.004 Abstract ( 287 )   PDF (1310KB) ( 107 )   PURPOSE: To observe the effect of shRNA interference with Ras convertase 1 (Rce1) gene expression on the radiosensitivity of oral squamous cell carcinoma (OSCC) cells. METHODS: CAL27 cells in log phase were taken and randomly divided into control group, shRNA-NC group and shRNA-Rce1 group. The control group was not treated, while shRNA-NC group and shRNA-Rce1 group were transfected with shRNA-NC and shRNA-Rce1 expression vector by liposome transfection method, respectively. Dimethylthiazole (MTT) method was used to detect the proliferation inhibition rate of different radiation doses (2, 4, 6, 8, 10 Gy) on CAL27 cells, and the half-dose radiation inhibitory amount on the cells was calculated. AnnexinV-FITC/PI double staining was used to detect the apoptosis rate. Western blot was used to detect the expression levels of cellular B-cell lymphoma-2(Bcl-2), Survivin and Caspase-3 (Caspase-3) protein. SPSS 19.0 software package was used for data analysis. RESULTS: Compared with the control group and shRNA-NC group, the inhibition rate of different radiation doses on CAL27 cell proliferation in the shRNA-Rce1 group were significantly increased, while the half inhibition dose was significantly decreased(P<0.05). Compared with the control group and shRNA-NC group, the apoptotic rate in the shRNA-Rce1 group was significantly increased (P<0.05). Compared with the control group and shRNA-NC group, the expression of Bcl-2 and Survivin protein in the shRNA-Rce1 group was significantly decreased, while the expression of Caspase-3 protein was significantly increased (P<0.05). CONCLUSIONS: shRNA interference with Rce1 gene expression can enhance the radiosensitivity of OSCC cells, reduce half inhibition dose, promote cell apoptosis, reduce the expression of apoptosis-inhibiting proteins Bcl-2 and Survivin, and increase the expression of apoptotic protein Caspase-3. References | Related Articles | Metrics

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Predictive value of four scoring systems on judging the need for tracheostomy in patients with oral cancers ZHU Bo-wen, ZHUANG Hai, Mao Qiu-yi, BU Shou-shan 2022, 20 (2):  129-134.  doi: 10.19438/j.cjoms.2022.02.005 Abstract ( 334 )   PDF (800KB) ( 99 )   PUPPOSE: This study was to assess and compare the predictive value of Kruse, Cameron, CASST and TRACHY tracheostomy scoring system on the need for tracheostomy in patients with oral cancers. METHODS: A retrospective analysis was conducted of clinical data of patients with oral cancers admitted to the Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Nanjing Medical University from December 2017 to July 2021. The clinical data were converted into total score of each scoring system, and the calculation and assessment were examined based on the recommended threshold. Receiver operating characteristic curve(ROC) analysis was used to examine the optimal threshold to reassess according to Youden index. The predictive value was compared by applying the area under receiver operating curve (AUC). The data were analyzed using SPSS 26.0 software package and MedCalc 20.0 software. RESULTS: Two hundred and thirty five cases were included in this retrospective study and the rate of tracheotomy rate was 9.8%(23/235). No emergency surgical airway management was performed after operation, and all patients were discharged with stable condition. All score systems performed poor positive predictive value before or after adjustment (0.28-0.4/0.19-0.45), the sensitivity was 0.39-0.91/0.87-0.91, the specificity was 0.75-0.93/0.61-0.88. AUC from greater to smaller was arranged as Cameron, TRACHY, CASST, Kruse tracheostomy scoring systems. There was significant difference of AUC between Cameron and Kruse scoring system(Z=2.014,P<0.05), Cameron and CASST scoring system (Z=1.996,P<0.05). CONCLUSIONS: Instead of effectively judging the need for tracheotomy, these four scoring systems may lead to a higher tracheostomy rate. References | Related Articles | Metrics

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Radiofrequency ablation combined with DSA-guided sclerotherapy of polidocanol foam for38patients with oral, maxillofacial venous malformation ZHUANG Qian-wei, LI Fang-fang, MENG Jian, GU Qian-ping, LI Zhi-ping 2022, 20 (2):  135-140.  doi: 10.19438/j.cjoms.2022.02.006 Abstract ( 257 )   PDF (1416KB) ( 120 )   PURPOSE: To investigate the effect of combination of radiofrequency ablation with DSA-guided sclerotherapy of polidocanol foam in patients with oral and maxillofacial venous malformations. METHODS: The clinical data of 38 patients with venous malformation in Xuzhou Central Hospital from 2019 to 2020 were retrospectively analysed. All patients underwent combined therapy of radiofrequency ablation with DSA-guided sclerotherapy of polidocanol foam. The curative effect was observed in follow-up of minimum 6 months. RESULTS: The patients were divided into 2 groups according to Puig's classification, type Ⅰ(n=20) and type Ⅱ(n=18). All patients underwent radiofrequency ablation as well as DSA-guided sclerotherapy of polidocanol foam for 2-4 sessions. Polidocanol foam was made by means of Tessari's method with the ratio of 1:3(1% polidocanol vs air). Eight cases were cured, 29 cases were basically cured and 1 was less effective. The cure rate was 21.05%(8/38), and the total effective rate was 97.37%(37/38). All 38 cases had mild swelling after sclerotherapy, and the swelling gradually subsided after 3 days. Two cases had skin tension blisters, and 1 case had mild skin ulceration cured after symptomatic treatment. No serious complications such as allergic reaction, ectopia embolism, local or systemic infection occurred. Postoperative follow-up was conducted for 6-12 months. No recurrence, choke, skin rupture, fistula and other serious complications were found. CONCLUSIOINS: According to Puig's classification, it is safe and effective to select combination of radiofrequency ablation with DSA-guided sclerotherapy of polidocanol foam in patients with oral and maxillofacial venous malformations. References | Related Articles | Metrics

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The relationship between serum IL-6, IL-17, TNF-α, IFN-γ levels, clinical characteristics of60patients with oral squamous cell carcinoma NUERMANGULI·Yasen, DUOLIKUN·Wufuer, BAIERNA·Wushuoer, YAN Guang-peng 2022, 20 (2):  141-145.  doi: 10.19438/j.cjoms.2022.02.007 Abstract ( 235 )   PDF (538KB) ( 114 )   PURPOSE: To investigate the relationship between serum IL-6, IL-17, TNF-α and IFN-γ levels and clinical characteristics of patients with oral squamous cell carcinoma(OSCC). METHODS: A total of 60 patients with OSCC and 60 patients with non-OSCC, who diagnosed at the People's Hospital of Xinjiang Uygur Autonomous Region from 2019 to 2021 were enrolled in the study; at the same time, 60 healthy people for normal physical examination were chosen as the control group, expression levels of IL-6, IL-17, TNF-α and IFN-γ were detected by flow cytometer, the relationship between serum IL-6, IL-17, TNF-α, IFN-γ levels and clinical features of OSCC patients was analyzed. Statistical analysis was performed with SPSS 22.0 software package. RESULTS: The levels of IL-6, IL-17, TNF-α in OSCC patients was positively associated with TNM stage and tumor size(P<0.05). No change was seen in IFN-γ in OSCC patients compared to other two groups(P>0.05). The concentration of IL-6, IL-17, TNF-α in OSCC patients were significantly higher than that in the non-OSCC group and the control group(P<0.05). The level of IFN-γ in OSCC patients were significantly lower than that in the control group (P<0.05). Diagnostic value analysis showed that the sensitivity and positive predictive value of IL-6, IL-17, TNF-α, IFN-γ were significantly improved. CONCLUSIONS: Serum IL-6, IL-17, TNF-α, IFN-γ levels may be related to the clinical characteristics of patients with OSCC. References | Related Articles | Metrics

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Rhabdomysarcoma of head, neck: clinical, pathological, prognosis analysis of101consecutive cases CHEN Yi-ming, Ahemd, JI Tong, REN Zhen-hu 2022, 20 (2):  146-150.  doi: 10.19438/j.cjoms.2022.02.008 Abstract ( 356 )   PDF (518KB) ( 102 )   PURPOSE: To analyze the clinical and pathological features as well as the prognostic factors for head and neck rhabdomyosarcoma(RMS). METHODS: A retrospective study of patients with head and neck RMS treated in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from 2006 to 2013 was conducted. The clinical, radiological, pathological, treatment information and follow-up records were collected. Statistical analysis was performed with SPSS 22.0 software package. RESULTS: A total of 101 patients were treated in the given time period, among them 75 were followed-up: 52 were male and 49 were female; 50 were younger than 18 years old, 51 were above 18 years old. Buccal mucosa, parotid region and skull base were the most common sites of the disease. Sixty-five cases were pleomorphic type, 27 were embryonal type and 9 were acinar type. Forty-four patients with IRS gradeⅠ, 39 with grade Ⅱ and 18 with grade Ⅲ. Twenty-nine subjects underwent surgery only, 20 subjects were managed simultaneously with both surgery and chemotherapy, 10 underwent surgery and radiotherapy, 42 were managed by tri-modality. Eight had positive cervical lymph node in final pathological results, no positive surgical margin was found. The 5-year disease free survival(DFS) was 41.3%, while the 5-year overall survival(OS) was 44.0%. CONCLUSIONS: Head and neck rhabdomyosarcoma has a poor 5-year OS and DFS, with IRS grades and tumor sites as the main independent prognostic factors for survival. Radical surgical treatment with negative margins is critical for RMS, and adjuvant therapies such as radiotherapy and chemotherapy may improve local control rate and survival rate of the patients. References | Related Articles | Metrics

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Preliminary establishment of Mandarin speech database of369Chinese oral cancer patients XIAO Yu-dong, GUO Kai-xin, YANG Le, DENG Wei, ZENG Bin, ZHANG Si-en, LAO Xiao-mei, LIAO Gui-qing, LIANG Yu-jie 2022, 20 (2):  151-157.  doi: 10.19438/j.cjoms.2022.02.009 Abstract ( 303 )   PDF (1637KB) ( 148 )   PURPOSE: To establish Mandarin speech database of Chinese oral cancer patients by collecting speech samples of patients with oral cancers before and after operation, so as to provide important data platform for clinical diagnosis, treatment and rehabilitation of oral cancer patients. METHODS: The patients from Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Sun Yat-Sen University were collected. A variety of speech corpus were applied to assess the participants and collect speech samples which were followed by uniform pre-processing, segmentation, annotation, and anonymization. A set of speech samples from relative health controls were also collected. RESULTS: A total of 481 individual speakers were enrolled from July 2017 to April 2021. The mean age at first assessment was 46.98±16.34 years. The participants consisted of 274 males(57.0%) and 207 females(43.0%). Of them, 369 patients with oral cancers（76.7%）, 79 healthy subjects(16.4%) and 33 subjects with non-malignant lesions(6.9%) were comprised. Among oral cancers, a sum of 258 patients had primary lesions located on the tongue and floor of the mouth, and 202 patients were recruited before surgery whose T classifications were 35 cases at T1(17.3%), 68 cases at T2(33.7%), 41 cases at T3(20.3%) and 58 cases at T4(28.7%). The median follow-up(assessment) time was 219 d(IQR: 87.5~587 d) after surgery with a sum of 1 100 appointments. A sum of 73 008 isolated audio samples were obtained from 461 kinds of corpus stimuli which consisted of vowels (6,1.30%), diadochokinesis syllables(7, 1.51%), single words (238, 51.63%), phrases (169, 36.66%) and sentences (38,8.24%). CONCLUSIONS: The present study established the first speech database whose speech samples were dominantly from oral cancers, which provided important data support for the in-depth study of clinical biomarkers and development of individualized speech rehabilitation. References | Related Articles | Metrics

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Application of digital surgery to improve the accuracy of surgical reconstruction of craniomaxillofacial deformities LIN Bo, YANG Hong-yu, YANG Hui-jun, ZHOU Tao, WANG Feng, ZHANG Tian-wen 2022, 20 (2):  158-163.  doi: 10.19438/j.cjoms.2022.02.010 Abstract ( 230 )   PDF (871KB) ( 119 )   PURPOSE: Craniomaxillofacial deformities caused by tumors and congenital development affect the function and appearance of patients. This study compared the advantages of digitally surgically assisted craniomaxillofacial deformity surgery versus conventional surgery and evaluated its long-term outcomes. METHODS: This was a prospective cohort study that included patients who required craniomaxillofacial deformity revision due to tumor, infection, congenital development, etc, via digitally assisted surgery or traditional empirical surgery. After inclusion in the study and follow-up as planned, surgery-related data and CT data were collected at baseline, intra-operative and postoperative follow-up periods, and the difference between the actual and ideal postoperative mandibles was calculated separately for the two groups using chromatographic error analysis with Mimics software. SPSS 21.0 software package was used to analyzed the data. RESULTS: A cohort of 72 cases of craniomaxillofacial deformities was established, with 36 cases in each group. Chromatographic error analysis showed a preoperative and postoperative deviation of (1.06±0.06) mm in the digital group and (1.23±0.06) mm in the control group, and multifactorial linear regression showed that digital surgery was significantly associated with better mandibular repair accuracy (P<0.05), and the complication rates were the same in both groups, with no serious adverse events. CONCLUSIONS: Digital surgical technique assisted craniomaxillofacial deformity revision surgery significantly improved accuracy compared to traditional empirical surgery without increasing surgical complications, and its safety is reliable with stable long-term results. References | Related Articles | Metrics

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Risk factors analysis of laryngospasm among1,428patients with oral, maxillofacial surgery in post-anesthetic care unit FEI Juan, YANG Yue-lai, HU Yin-qing 2022, 20 (2):  164-167.  doi: 10.19438/j.cjoms.2022.02.011 Abstract ( 305 )   PDF (525KB) ( 141 )   PURPOSE: To explore the risk factors of laryngospasm among patients with oral and maxillofacial surgery in post-anesthetic care unit. METHODS: From March 2020 to June 2021, 1 428 patients undergoing oral and maxillofacial surgery in PACU were recruited. Socio-demographic and surgical-anesthesia related characteristics of participates were evaluated and the patients were divided into non-laryngospasm group and laryngospasm group. SPSS 22.0 software package was used to analyze risk factors of laryngospasm among patients. RESULTS: A total of 1 428 patients after oral and maxillofacial surgery were selected in this study, including 868 males and 560 females, aged 20-78 years, with an average age of (46.34±11.23) years. There were 114 patients with laryngospasm in post-anesthetic care unit, and the incidence rate was 7.98%. Logistic analysis showed that age (P=0.002), smoking (P=0.016), BMI(P=0.003), history of upper respiratory tract (P=0.004), Ramsay sedation(P=0.006) and times of sputum suction (P=0.047) in post-anesthetic care unit were the risk factors of laryngospasm. CONCLUSIONS: Old age, smoking, obesity, history of upper respiratory tract, lack of sedation and repeated sputum suction were the risk factors of laryngospasm in patients with oral and maxillofacial surgery in post-anesthetic care unit. Anesthesia care providers should strengthen the awareness of early warning of laryngospasm, promote the observation and preventive measures of laryngospasm, so as to improve the safety of patients during perioperative anesthesia. References | Related Articles | Metrics

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A5-year follow-up study of peri-implant bone resorption of zirconia implants in78consecutive cases SUN Dan-dan, SHI Sa-sa, YIN Wei-jiao 2022, 20 (2):  168-172.  doi: 10.19438/j.cjoms.2022.02.012 Abstract ( 279 )   PDF (672KB) ( 88 )   PURPOSE: To analyze peri-implant bone resorption of zirconia implants, so as to evaluate the value of zirconia all-ceramic restorations for clinical use. METHODS: Seventy-eight patients receiving all-ceramic fixed partial denture with zirconia framework from January 2014 to January 2016 were prospectively enrolled, and a five-year follow-up was carried out. The restoration integrity, margin sealing, implant retention rate, modified sulcus bleeding index (mSBI), modified plaque index (mPLI) and probing depth (PD) were evaluated. Radiographs were used to evaluate implant marginal bone resorption, and the related factors affecting bone resorption were determined using multiple linear regression analysis. SPSS19.0 software package was used for data analysis. RESULTS: The follow-up period was 5 years. During the follow-up period, a total of 6 patients were lost to follow-up. The remaining 72 patients (a total of 80 implants and 63 prostheses) completed the follow-up. None of the implants showed loosening, fracture or displacement. Porcelain fragmentation occurred in 6 restorations, poor fit between the crown edge and the abutment occurred in 2 restorations, and no restorations fell off. The mean value of marginal bone resorption was (0.23±0.04) mm(0-2.03 mm). Statistical analysis displayed that history of diabetes, porcelain fragmentation and type of dental implant affected peri-implant bone resorption of zirconia implants(P<0.05). CONCLUSIONS: Long-term follow-up results show that zirconia implant is a reliable implant system with high survival rate, good soft tissue aesthetic effect, and marginal bone stability. References | Related Articles | Metrics

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Evaluation of MRI image texture analysis in differential diagnosis of benign, malignant parotid gland tumors QU Jun-chen, JIA Chuan-hai, DING Qing-guo, CAO Rui, QIU Jia-ming 2022, 20 (2):  173-176.  doi: 10.19438/j.cjoms.2022.02.013 Abstract ( 264 )   PDF (503KB) ( 105 )   PURPOSE:This study was intended to use MaZda software to explore image texture analysis value of T1WI, T2WI, T1WI enhancement, DWI map in differential diagnosis of benign and malignant parotid gland tumors. METHODS: A total of 131 cases undergoing MRI examination and surgery during 2015 to 2019 were included. A radiologist used MaZda software to draw ROIs from the selected images which contained maximal layer of lesions to obtain individual texture feature values. B11 statistical software module from MaZda software was used to classify benign and malignant parotid gland tumors according to the selected texture features. RESULTS: The discriminant ability of texture analysis based on T2WI maps was better than that based on the other three sequence images. In raw data analysis(RDA), principal component analysis(PCA), linear discriminant analysis(LDA) and nonlinear discriminant analysis(NDA) of the four classification methods were carried out. the misclassification rate of NDA method to identify benign and malignant parotid gland tumor was significantly lower than other kinds of methods. CONCLUSION: Texture analysis based on T2WI maps can be used as an auxiliary method to provide reliable and objective evidence for differential diagnosis of benign and malignant parotid gland tumors. NDA is more effective than RDA,PCA,LDA in differential diagnosis. Attention should be paid to its generalization ability and sample-dependent characteristics in clinical application. References | Related Articles | Metrics

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Evaluation of the value of contrast-enhanced ultrasonography in diagnosis of43patients with parotid tumors CHEN Ze-yuan, LIU Yi-bin, ZAIMIRE Yibulayin, ZHANG Si-min, MAIMAITITUXUN Tuerdi 2022, 20 (2):  177-183.  doi: 10.19438/j.cjoms.2022.02.014 Abstract ( 267 )   PDF (1133KB) ( 104 )   PURPOSE: To evaluate the value of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of parotid tumors. METHODS: This study cohort comprised 43 patients with parotid gland tumors. The pathological classification of tumors included 31 benign tumors and 12 malignant tumors. The characteristics of CEUS images collected during ultrasound examination included wash-in pattern (fast in, slow in or isochronous), wash-out pattern (fast out, slow out and isochronous), enhancement intensity (hight, equal or low), and texture of enhancement (homogeneous and heterogeneous ).The region of interest (ROI) was outlined, the time intensity curve (TIC) was drawn, and the quantitative parameters were obtained through instrumental analysis, including time of arrival (AT), time of peak arrival (TTP), peak intensity (PI), ascending slope(AS), descending time/2 (DT/2), half falling branch slope (DS) and area under the curve(AUC). Then, through the travel value of the parameters between the tumor and surrounding normal tissue, △symbol was added before using the parameters. Based on the analysis of the data, CEUS performance among parotid tumors and difference of quantitative parameters were obtained, and then quantitative parameters were drawn to the working characteristic curve of the subjects to get the best cut-off value, sensitivity and specificity. SPSS 25.0 software package was used for data analysis. RESULTS: There were significant differences between benign parotid tumors and malignant tumors in wash-in pattern, wash-out pattern, enhancement intensity and texture of enhancement(P<0.05).There was significant difference in △AUC between pleomorphic adenomas (PA) and Warthin's tumor (WT) in benign parotid tumors (P<0.05). There were significant differences in DS, AUC, △PI, △AS and △AUC between benign and malignant parotid tumors(P<0.05). Analysis of ROC curve showed that the best cut-off value of △AUC of PA and WT was -103.94, the sensitivity was 100%, and the specificity was 46.20%（ROC-AUC=0.766,P<0.05）. In benign and malignant tumors of parotid gland, the best cut-off value of AUC was 1422.165, the sensitivity was 83.30%, the specificity was 60%（ROC-AUC=0.728,P<0.05）; the best cut-off value of PI was 0.535, the sensitivity was 83.30%, and the specificity was 60%(ROC-AUC=0.794,P<0.05); the best cut-off value of △AUC was 271.37, the sensitivity was 91.7%, and the specificity was 60% (ROC-AUC=0.797, P<0.05). CONCLUSIONS: CEUS has important value in differential diagnosis of parotid tumors. References | Related Articles | Metrics

Clinical Reports

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Used of three different approaches for surgical treatment of adult condylar fracture GAO Zhi-biao, WANG Lei, XIAO Xia, GAO Duo-duo 2022, 20 (2):  184-187.  doi: 10.19438/j.cjoms.2022.02.015 Abstract ( 276 )   PDF (1620KB) ( 154 )   PURPOSE: This study aimed to evaluate and compare clinical outcomes of three different surgical approaches for adult condylar fractures. METHODS: A total of 46 cases with 48 fracture sites were classified according to the standard of Loukota et al. Condylar fractures of the mandible were managed by open reduction and internal fixation via anterior auricular, retromandibular incision through parotid gland and transoral surgical approaches based on the classification. RESULTS: Dental occlusion,mandibular movement,mouth opening,and anatomic reduction were restored in all 46 patients with condylar fractures. No patient showed condylar head resorption. CONCLUSIONS: Different surgical approaches can achieve satisfactory outcomes according to different types of adult condylar fractures. References | Related Articles | Metrics

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Application of digital, 3D printing combined with endoscopic assisted technology in the treatment of12patients with zygomatic, zygomatic arch fractures LUO Bin, ZHOU Mei-yun, TIAN Xiu-yun, CHEN Xin-ru, HAN Rui, XU Jin-cheng 2022, 20 (2):  188-192.  doi: 10.19438/j.cjoms.2022.02.016 Abstract ( 281 )   PDF (2119KB) ( 152 )   PURPOSE: To explore the application and effect of digital and 3D printing combined with endoscopic-assisted technology in the treatment of zygomatic bone-zygomatic arch fractures. METHODS: Twelve patients with unilateral zygomatic fractures who underwent surgical treatment in First Affiliated Hospital of Bengbu Medical College from December 2020 to September 2021 were included in this study. All patients underwent 3-D CT reconstruction of the whole head before operation, by simulating reduction of the fracture site using the principle of mirror reverse, printing the fracture model after reduction, and performing titanium pre-bending on the model. Intraoperatively, the fracture was dissected and repositioned using an endoscopically assisted vestibular sulcus incision combined with an anterior auricular incision. All patients underwent 3-D CT reconstruction of the whole head again after operation. The three-dimensional model data reconstructed after operation and the 3-D model data before preoperative simulated reduction were analyzed by spectral fusion chromatic aberration to evaluate the postoperative effect. RESULTS: The operation in 12 patients went smoothly. The facial appearance and function recovered well after operation. There was no obvious complication and the facial skin scars were inconspicuous. Compared with postoperative CT and preoperative simulated design spectral fusion chromatic aberration analysis; the maximum upper deviation was 2.998 7 mm, the maximum lower deviation was -2.998 6 mm, the average upper deviation was (0.243 0±0.025 0) mm, the average lower deviation was (-0.310 0±0.180 0) mm. CONCLUSIONS: Digital and 3D printing combined with endoscopic-assisted techniques help improve the accuracy of fracture reduction, reduce intraoperative tissue damage, postoperative complications, and provide good aesthetics with hidden postoperative scars when performing anatomical repositioning of the fracture site under direct vision. References | Related Articles | Metrics

Review Articles

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Understanding oral cancer invasion from the perspective of genetic heterogeneity QU Chu-xiang, SUN Shu-yang, ZHANG Zhi-yuan 2022, 20 (2):  193-197.  doi: 10.19438/j.cjoms.2022.02.017 Abstract ( 296 )   PDF (477KB) ( 117 )   The invasive front of oral cancer is a region characterized by detached mesenchymal-like tumor cells or cell groups. The process of the formation of the invasive front should be interrogated in order to understand tumor invasion. A certain degree of intratumor heterogeneity and clonal relationship exists between the tumor body and the invasive front. Understanding tumor invasion at genetic level requires revealing the clonal structure as well as the evolutionary relationship between the tumor body and the invasive front. The key genetic events driving tumor invasion can also be detected by reconstructing the clonal structure of the two tumor regions, on the basis of which potential therapeutic targets or biomarkers in invasion can be identified. The evolutionary trajectories in the invasion process of oral squamous cell carcinoma (OSCC) showed a great deal of intertumor heterogeneity. Researches in other cancers also found intertumor heterogeneity in the evolutionary patterns and further revealed the evolutionary process of invasive subclones and interactions between subclones. This review aimed at understanding tumor invasion in OSCC from a genetic perspective and extending our understanding of the key genetic events, genetic heterogeneity and clonal evolution during tumor invasion through evaluation of current knowledge in tumor invasion in other cancer types. References | Related Articles | Metrics

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Research progress on socket shield technique concurrent with implantation in aesthetic area ZHOU Yi-ning, GU Ying-xin 2022, 20 (2):  198-201.  doi: 10.19438/j.cjoms.2022.02.018 Abstract ( 238 )   PDF (522KB) ( 148 )   Resorption of labial bone plate due to teeth extraction can affect the aesthetic outcome of maxillary anterior teeth negatively, therefore, socket shield technique was introduced to reduce labial bone loss by preserving bundle bone-periodontal ligament apparatus. This article reviewed related literatures of socket shield technique in recent years, summarizing the advantages and limitations of the technique compared with conventional immediate implantation, and factors that influence its effectiveness. References | Related Articles | Metrics

Case Reports

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Metastatic small cell neuroendocrine carcinoma of tongue base: a case report, review QIAN Min, SHEN Yue-hong, WU Li, YANG Hong-yu 2022, 20 (2):  202-205.  doi: 10.19438/j.cjoms.2022.02.019 Abstract ( 369 )   PDF (2370KB) ( 148 )   Extra-pulmonary small cell neuroendocrine carcinoma is rare and very highly malignant disease, which is generally diagnosed at an advanced stage and has a poor prognosis. The diagnosis is based essentially on the morphological appearance of the tumor, confirmed by immunocytochemical features. We here contributed by reporting a case of tongue metastasis from primary cervical small cell neuroendocrine carcinoma and reviewed the current literatures about its diagnosis and treatment. References | Related Articles | Metrics

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Mandibular congenital granular cell epulis: a case report XUE Tao, LIU Rui, Cai Xin-yun, ZHANG Yong-hong, ZHANG Lei-lei, DONG Jin-long 2022, 20 (2):  206-208.  doi: 10.19438/j.cjoms.2022.02.020 Abstract ( 341 )   PDF (1198KB) ( 85 )   Congenital granular cell epulis (CGCE), also known as congenital epulis of the newborn, is a rare, congenital, benign oral soft tissue tumor of unknown etiology. This paper reported a case of CGCE, and reviewed relevant literature to discuss the clinical and pathological features, differential diagnosis and treatments of this tumor, in order to improve doctors' understanding of this tumor. References | Related Articles | Metrics