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    Chinese Expert consensus on the diagnosis, treatment of odontogenic keratocyst
    LIU Bing, HE Yue, PENG Xin, SUN Chang-fu, HAN Zheng-xue, WU Yu-nong, PENG Li-wei, ZHAO Yi, TAO Qian, HAN Xin-guang, LI Jin-song, SU Tong, LI Bo, ZHANG Lei, HU Yan-ping, CHEN Chuan-jun, LI Yi, LI Tie-jun, ZHAO Yi-fang
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 209-218.   DOI: 10.19438/j.cjoms.2022.03.001
    Abstract1951)      PDF (1176KB)(916)      
    Odontogenic keratocyst (OKC) is a common cystic lesion of the jaw. The nomenclature and nature of OKC remain controversial as a result of its local invasive behavior and high tendency of recurrence, which is evidently different from other types of jaw cysts. With the in-depth study of OKC pathogenesis and the advance of treatment concept and surgical techniques, it becomes possible to reduce the rate of postoperative recurrence and simultaneous functional reconstruction of the jaw. To establish standard diagnosis and treatment algorithms or guidelines of OKC, we organized peer experts in China to reach a consensus on pathogenesis, clinical manifestations, imaging characteristics, histopathological features, surgery and postoperative follow-up strategies of OKC for the references of clinicians.
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    Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas(version 2022)
    ZHENG Jia-wei, WANG Xu-kai, QIN Zhong-ping, FAN Xin-dong, LI Kai, YANG Yao-wu, HUO Ran, LIU Shao-hua, ZHAO Ji-hong, WANG Xiao-yong, ZHOU De-kai, LIU Xue-jian
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (4): 313-319.   DOI: 10.19438/j.cjoms.2022.04.001
    Abstract1305)      PDF (1061KB)(1201)      
    Since 2008, propranolol has become the first-line treatment for infantile hemangiomas. Many researches have been reported on its treatment mechanism both at home and abroad, and several expert consensus or clinical practice guidelines have been formulated and published. In recent years, with the continuous accumulation of clinical experience, increasing number of basic research works, and deepening understanding of the pathogenesis of hemangioma and the mechanism of action of propranolol, it is necessary to update the expert consensus to be more consistent with clinical practice, in order to guide medication and management, provide scientific norms for the clinical use of propranolol in the treatment of infantile hemangiomas. This updated version mainly simplified the process of clinical examination, medication, and monitoring, making it more convenient and operable.
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    Efficacy of I.lanceolatum injection on postoperative reaction following dental implant surgery
    ZHU Qing-qing, SUN Qiang, WANG Dong-ling, ZHOU Hong
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 230-234.   DOI: 10.19438/j.cjoms.2022.03.004
    Abstract1269)      PDF (607KB)(100)      
    PURPOSE: The aim of this study was to explore the effects of i.lanceolatum injection on postoperative reaction , following the placement of dental implants with guided bone regeneration(GBR). METHODS: Ninety patients requiring dental implants with GBR were included in this randomized controlled clinical trial. The patients were evenly divided into 3 groups. I.lanceolatum injection was adopted in the experimental group after surgery, dexamethasone injection was adopted in the control group, and patients didn't receive any injection in the blank group. Postoperative pain, swelling, early wound healing, and satisfaction were analyzed and evaluated after follow-up appointments at day 1, day 3, and day 7. SPSS 25.0 software package was used for data analysis. RESULTS: The experiment group had significantly lower pain and swelling indices than the blank group at day 1 and 3(P<0.05); it also had higher wound healing indices than the blank group at day 1 and 3(P<0.05). Operative satisfaction indices of the experimental and control group were significantly higher than the blank group(P<0.05). CONCLUSIONS: Postoperative adverse reactions can be improved by using i.lanceolatum injection following dental implant surgery with GBR.
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    Mechanism of EGFR-targeted drugs for pain relief in oral cancer
    WEI Dong-liang, LI Zhi, JU Hou-yu, WU Yun-teng, GUO Wei, REN Guo-xin
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 219-224.   DOI: 10.19438/j.cjoms.2022.03.002
    Abstract1218)      PDF (907KB)(367)      
    PURPOSE: The purpose of this study was to investigate whether drugs targeting EGFR (erlotinib, Nimotuzumab) could affect the pain threshold of experimental animals and to preliminarily explore the mechanism. METHODS: Naive mice were divided into two groups(physiological saline, n=6; erlotinib, n=6), the difference of pain threshold between the two groups was compared by Von Frey fiber test, hot plate test and 5% formalin test 1 h after administration. Nude mice were selected and divided into 3 groups (Sham + NS group, n=10; Plantar neoplasia + NS group, n=10; Plantar neoplasia + Nimotuzumab group, n=10). The mechanical pain threshold and thermal pain threshold of the mice were detected 1d before modeling and 1, 5, 7, 10 and 14 d after modeling. The mouse feet were dissected 14 days later, and the concentrations of IL-1β and IL-6 were detected by ELISA after tissue homogenization. The data were processed by Graphpad Prism statistical software. RESULTS: After erlotinib injection, the mechanical pain threshold and thermal pain threshold of mice had no obvious changes. After injection of 5% formalin in mice, the duration of licking in the anterior phase (0-10 min, P<0.01) and posterior phase (10-60 min, P<0.01) decreased significantly. Heat and mechanical pain sensitivity could be induced after plantar tumor formation in nude mice. Nimotuzumab slowed down tumor growth rate and increased thermal pain threshold (P<0.05) and mechanical pain threshold (P<0.05) in plantar tumorigenic mice. ELISA showed that the concentration of IL-1β (P<0.05) and IL-6 (P<0.05) in the plantar tissue of mice in the Nimotuzumab treatment group was significantly lower than that of the PBS treatment group. CONCLUSIONS: Erlotinib can alleviate pain induced by formalin in mice. Nimotuzumab can reduce mechanical and thermal pain sensitivity induced by plantar tumor formation, and the mechanism may be related to the decrease of inflammatory cytokines in local tissues. EGFR-targeted drugs may be one of the good analgesics for patients with advanced cancer pain.
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    Clinicopathological characteristics and prognostic analysis of oral squamous cell carcinoma with parotid lymph node metastasis
    LI Xing, XU Fei-hu, YANG Yun-bo, HAN Nan-nan, RUAN Min
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (1): 28-31.   DOI: 10.19438/j.cjoms.2022.01.005
    Abstract1214)      PDF (717KB)(214)      
    PURPOSE: To investigate the clinical regularity of oral squamous cell carcinoma(OSCC) with parotid lymph node metastasis and its influence on prognosis. METHODS: A retrospective analysis of the clinicopathological data of 60 oral squamous cell carcinoma patients with or without parotid lymph node metastasis admitted to Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from January 2003 to December 2017 was conducted. SPSS 23.0 software package was used for data analysis. RESULTS: Primary tumor T stage(P=0.022) and cervical lymph node status(N stage, P=0.008) were closely related to parotid lymph node metastasis. Parotid metastatic lymph nodes were mostly located in the lower pole of the superficial parotid gland and prone to extracellular invasion(P<0.05). Parotid gland lymph node metastasis is closely related to the prognosis of oral squamous cell carcinoma(P=0.0004), and the 5-year survival rate of gingival squamous cell carcinoma with parotid lymph node metastasis was significantly higher than that of tongue squamous cell carcinoma(P=0.0427). CONCLUSIONS: Parotid lymph node metastasis is a poor prognostic factor for oral squamous cell carcinoma. Higher T and N stages are two important factors that promote LN metastasis to parotid gland in OSCC patients.
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    Expert consensus on diagnosis and clinical management of medication-related osteonecrosis of the jaw
    HE Yue, CHEN Heng, AN Jin-gang, GUO Yu-xing, PAN Jian, TIAN Lei, LIU Bing, HOU Jin-song, LI Jin-song, JIANG Can-hua, LI Meng-yu, TIAN Zhen, XU Jie, ZHU Ling, SUN Chang-fu, ZHI Ke-qian, QU Qing, ZONG Chun-lin, SUN Jing-jing, ZHANG Zhi-yuan
    China Journal of Oral and Maxillofacial Surgery    2023, 21 (4): 313-325.   DOI: 10.19438/j.cjoms.2023.04.001
    Abstract1169)      PDF (2051KB)(1409)      
    Medication-related osteonecrosis of the jaw(MRONJ) is a complication caused by the application of anti-resorptive medications, angiogenesis inhibitors, hormones and other medications for the treatment of some systemic diseases. The clinical symptoms include swelling, pain, masticatory disorders, persistent fistula, bone exposure and even pathological fracture, which seriously affect the patients' quality of life. Domestically, there is a lack of consensus or guidelines on classification, staging and treatment of MRONJ, and different institutions make diagnosis and treatment plans empirically. In order to unify and standardize the diagnosis and treatment of MRONJ and improve the prognosis, an expert panel of MRONJ research from 12 famous domestic medical colleges and affiliated hospitals convened a meeting to discuss the diagnosis and treatment opinions of MRONJ. Meanwhile, consensus recommendations were also revised with a comprehensive literature review of the previous treatment experiences and research findings. Finally, this expert consensus was finished for clinical references.
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    Neoadjuvant immunotarget therapy in patients with locally advanced oral squamous cell carcinoma: report of 2 cases and literature review
    ZHANG Yi-yi, YANG Yue-yi, JU Wu-tong, ZHONG Lai-ping
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (4): 413-416.   DOI: 10.19438/j.cjoms.2022.04.018
    Abstract1017)      PDF (938KB)(137)      
    Neoadjuvant therapy is systemic therapy before local treatment in patients with non-distant metastatic malignancies, aiming to reduce tumor load and distant metastasis, increase opportunity of radical resection, and relieve symptoms, et al. In this report, we presented two patients with locally advanced oral squamous cell carcinoma, who were treated with camrelizumab and apatinib as neoadjuvant therapy in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, and reviewed and discussed the relevant literatures.
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    Application of ultrasound assisted parotid flap sialolithotomy for deep parotid stones: report of 5 cases
    JIN Zhi-lei, LIU Wei-jun, WU Guo-rong, ZHOU Qin, SHI Huan
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (1): 77-80.   DOI: 10.19438/j.cjoms.2022.01.015
    Abstract775)      PDF (724KB)(144)      
    PURPOSE: To explore the clinical value of ultrasound-assisted parotid flap sialolithotomy in the treatment of deep parotid duct stones. METHODS: From January 2019 to June 2020, five patients with deep parotid duct stones in the Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, were collected. Preoperative CT scan showed that the stones were located in the intraparenchymal duct, which was at the anterior edge of the masseter muscle. The patient underwent parotid flap stone extraction under general anesthesia. During operation, a small S-shaped incision was designed behind the ear with the aid of B-ultrasound. The marginal mandibular branch of the facial nerve was dissected to expose the duct in the gland where the stone was located. Then, the wall of the duct wall was cut to remove the stone, and the duct was sutured tightly. Follow-up data were collected at 1 week, 3 months, and 12 months after operation. RESULTS: All stones were successfully removed. One patient developed symptoms of parotid duct obstruction after operation, which improved after washing and dilatation treatment. No facial nerve injury, salivary fistula, infection and other complications occurred. The clinical symptoms before surgery were completely relieved at 12-month follow-up, and the curative effect was satisfactory. CONCLUSIONS: Ultrasound-assisted parotid flap sialolithotomy for deep parotid duct stones has a high success rate, good curative effect, and is worth of wide application.
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    Chinese expert consensus statement on the application of of indocyanine green(ICG) fluorescence imaging in the treatment of oral squamous cell carcinoma
    WANG Yu-xin, WANG Zhi-yong, WANG Yong-gong, WANG Hui-ming, WANG Li-zhen, TIAN Hao, YE Jin-hai, FU Kun, RUAN Min, SUN Chang-fu, SUN Guo-wen, LIU Fa-yu, XU Bi-yun, HOU Jun, LIU Bing, LIU Liang, CHEN Yong-feng, CHEN Zhan-wei, XIAO Can, LI Si-yi, LI Zhi-yong, LI Yong, LI Nan, ZHANG Chen-ping, ZHANG Dong-sheng, ZHANG Sheng, ZHANG Kai, YANG Xi, HE Wei, SU Tong, JI Tong, LIN Li-song, LUO Rui-hua, ZHAO Zhi-li, HU Qin-gang, TANG Zhan-gui, XU Wei-jia, HUANG Zhi-quan, HUANG Xiao-feng, LIANG Yu-jie, HAN Zheng-xue, HAN Wei, JIANG Can-hua, YU Jian-jun, CAI Zhi-gang, LIAO Gui-qing, LIAO Sheng-kai, CAI Hui-ming, WEI Jian-hua
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (1): 1-6.   DOI: 10.19438/j.cjoms.2022.01.001
    Abstract769)      PDF (847KB)(478)      
    Indocyanine green (ICG) is a near-infrared fluorescent dye. Based on the enhanced permeability and retention (EPR) effect, the ICG fluorescence imaging was applied extensively in biomedical fields. The technique could sensitively detect imaging difference between the tumor and surrounding tissue, and define the tumor border to assist in tumor resection. Nevertheless, the application in the treatment of oral squamous cell carcinoma (OSCC) is still at the neonate stage. Thereby, its indication, standard operation procedure and caution required normalization. On the Evidence-based approaches including multi-center study, systemic reviews of related scientific publications,the Chinese experts reach a consensus of ICG fluorescence imaging technique to instruct the clinical practice of OSCC surgery.
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    Expert consensus on clinical diagnosis and treatment for Chinese oral mucosal melanoma
    GUO Wei, REN Guo-xin, SUN Mo-yi, KONG Yun-yi, WANG Li-zhen, BU Rong-fa, RAN Wei, TANG Zhan-gui, LI Long-jiang, MENG Jian, SUN Zhi-jun, SHANG Wei, LV Jiong, WU He-ming, ZHANG Chen-ping, HE Yue, MA Xu-hui, SONG Hao, JU Hou-yu, ZHENG Jia-wei, GONG Zhong-cheng, YANG Kai, ZHANG Jie, WU Yun-teng
    China Journal of Oral and Maxillofacial Surgery    2021, 19 (6): 481-488.   DOI: 10.19438/j.cjoms.2021.06.001
    Abstract753)      PDF (1408KB)(726)      
    [Summary] Head and neck mucosal melanoma (HNMM) is a kind of highly malignant solid tumor. The 5-year survival rate of HNMM is about 20% for a long time. Its pathogenic factors, driving genes, clinical manifestations and treatment methods are quite different from skin melanoma. In 2015, the first Chinese expert consensus on the diagnosis and treatment of head and neck mucosal malignant melanoma was established. After more than six years of application, the clinical diagnosis and treatment of HNMM has been greatly improved. With the deepening of clinical and basic research on mucosal melanoma, the diagnosis, treatment and prognosis of HNMM have changed greatly in recent years, especially with the vigorous development of various branches of head and neck. Oral, nasal, sinus, eye and other mucosal melanoma have developed their own unique diagnosis and treatment model. This consensus can’t meet the actual needs of the current clinical practice. In this regard, the expert group believes that head and neck mucosa contains a wide range of anatomy, involving more clinical departments, and the diagnosis and treatment mode of melanoma varies significantly between different disciplines. It is urgent to meet the clinical consensus of more specialized diagnosis and treatment of individualized treatment and precise treatment. In order to further improve the long-term survival rate and quality of life of oral mucosal melanoma (OMM) and make the consensus to better guide clinical work, this expert group will focus on OMM and conduct in-depth discussion, and establish expert consensus based on evidence-based medicine and empirical medicine. Considering the individual differences of patients, this consensus can be used as a reference for clinical practice of OMM.
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    Imaging features of temporomandibular joint disorder: comparison of the efficacy of cone-beam CT, MRI
    CHEN Jian-rong, DING Shui-qing, CHEN Liang, HE Jia-jia, QI Rong-xing
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 273-276.   DOI: 10.19438/j.cjoms.2022.03.012
    Abstract721)      PDF (460KB)(261)      
    PURPOSE: To analyze the features on cone-beam CT (CBCT) and MRI of temporomandibular joint disorder (TMD). METHODS: The data of 45 patients with TMD treated in Nantong Hospital of Stomatology from August 2018 to May 2020 were collected. All patients completed CBCT and MRI within 2 weeks, and the characteristics of TMJ and masticatory muscle lesions on CBCT and MRI were evaluated, including joint space stenosis, bone destruction, bone hyperplasia and sclerosis, condyle deformation, bone cystoid degeneration, articular disc displacement, joint capsule effusion and masticatory muscle lesions. SPSS 25.0 software package was used for data analysis. RESULTS: According to TMD clinical classification, 31 cases (68.9%) were classified as type I painful diseases, and 14 cases (31.1%) were classified as type II joint diseases. Among the 90 joints of 45 patients, the number of TMJ and masticatory muscle lesions detected by MRI (71/90) was significantly higher than the number of lesions detected by CBCT (58/90) (P=0.032). Among them, the number of articular disc displacement (19/90), joint capsule effusion (28/90) and masticatory muscle edema (22/90) were significantly higher than the number of cases detected by CBCT which was 3/90, 8/90 and 5/90 (P<0.001). The number of cases of hyperosteosis (18/90) and condyle mutation (15/90) detected by CBCT was significantly higher than the number of cases detected by MRI which was 8/90 and 6/90 (P<0.05). CBCT and MRI had no significant differences in detecting joint space stenosis, bone destruction and cystoid degeneration(P>0.05). CONCLUSIONS: Both CBCT and MRI have high clinical value in evaluating TMD. CBCT has advantages in evaluating bone quality, while MRI has a good effect in evaluating joint discs and soft tissues.
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    Comparison of the effect of two kinds of biopsy on prognosis of oral mucosal malignant melanoma - a retrospective analysis of156cases
    HAN Ru-xue, MA Xu-hui, LI Zhi, REN Guo-xin, GUO-Wei, WU Yun-teng, LIANG Xiang
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 235-238.   DOI: 10.19438/j.cjoms.2022.03.005
    Abstract691)      PDF (682KB)(149)      
    PURPOSE: To compare the effect of two kinds of biopsy on prognosis of oral mucosal malignant melanoma (OMM), in order to find an optional biopsy method for OMM. METHODS: Patients with OMM treated at Shanghai Ninth Hospital, Shanghai Jiao Tong University School of Medicine from Jan.2010 to Jan.2018 were retrospectively analyzed. Correlation between biopsy methods and prognosis were explored. Overall survival (OS) was the primary outcome, and OS was the time from pathological diagnosis to the date of death or follow-up (September 1, 2021). SAS 9.3 software was used for statistical analysis. RESULTS: Univariate analysis showed that T stage, cervical lymph node(CLN) status, biopsy type and OS were statistically correlated. All the three variables were included in Cox regression model for multivariate analysis. The results showed that T stage, CLN and biopsy type were independent prognostic factors of OS(P<0.05). CLN and biopsy methods were identified as prognostic factors. Incidences of CLN and distant metastasis were both significantly less in cryogenic biopsy group than in incisional biopsy group (53% vs. 74% and 22% vs. 42%, Log-rank=12.955, P<0.01 respectively). The 3- and 5-year OS was significantly longer in cryogenic biopsy group than in incisional biopsy group (65% vs. 42%,Log-rank=12.570, P<0.01 and 54% vs. 20%, Log-rank=7.203, P<0.01, respectively). CONCLUSIONS: The 3- and 5- year OS in cryogenic biopsy group was significantly better than that in the incisional biopsy group. Cryogenic biopsy could significantly reduce CLN and distant metastasis of OMM. Therefore, Use of cryogenic biopsy instead of incisional biopsy to clarify the diagnosis of OMM is recommended.
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    Application and advancement of minimally invasive instruments and micro-power devices in tooth extraction
    LI Yan-xiang, YAN Li-jun, LING Xiao-wan, ZHOU Wen-jie, WANG Yue-ping
    China Journal of Oral and Maxillofacial Surgery    2023, 21 (2): 191-196.   DOI: 10.19438/j.cjoms.2023.02.016
    Abstract673)      PDF (914KB)(417)      
    Tooth extraction is to remove the affected teeth that can no longer provide oral function, and it is also one of the most basic and common procedures in alveolar surgery. Conventional tooth extraction applies elevators, forceps, chisels and other instruments, which may cause severe physical and psychological trauma to the patient. In recent years, the concepts of minimally invasive tooth extraction has been accepted in the clinic, and the development of materials has led to more refined extraction instruments. Meanwhile the use of micro-power devices has greatly improved the efficiency of tooth extraction. Advancements in tooth extraction techniques and equipments are aimed to maximumly preserve the integrity of the alveolar bone, reduce the complications, and relieve the pain. This paper described the development of minimally invasive tooth extraction techniques through the evolution of instruments and the application of micro-power devices, so as to provide reference for more dentists to understand and apply minimally invasive equipments in daily practice.
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    Sialadenoma papilliferum:a clinicopathologic study of one case
    HAN Lin-zi, FANG Yi-kang, YU Wen-yi, WANG Qi-min, TONG Lei, QIU Jian-zhong, YUAN Rong-tao
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (1): 98-100.   DOI: 10.19438/j.cjoms.2022.01.019
    Abstract666)      PDF (819KB)(286)      
    Sialadenoma papilliferum(SP) is a kind of rare benign tumor of salivary glands without pain and showing a characteristic papillary growth, it was classified as a ductal papilloma in the WHO's latest tumor classification. The lesions mainly affect the minor salivary glands and the most common site was the palate. The purpose of this paper was to describe a case of sialadenoma papilliferum occurring in mandibular retromolar region and discuss its clinical features and histopathology.
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    Research progress of the anatomy of maxillary sinus and the complications of external maxillary sinus lifting surgery
    WU Jiong-rui, GAO Yi-ming
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (1): 93-97.   DOI: 10.19438/j.cjoms.2022.01.018
    Abstract663)      PDF (535KB)(249)      
    When performing implantation in the posterior maxillary region, the clinical condition of insufficient residual alveolar bone often occurs. External maxillary sinus lifting surgery can achieve the purpose of vertical bone reconstruction, which has become a common clinical means. Because of the influence of anatomical structure variation of maxillary sinus, such as thickening of mucosa, existence of septum, and deviation of maxillary sinus artery , intraoperative and postoperative complications are not rare, such as perforation of the Schneiderian membrane, intraoperative hemorrhage, maxillary sinusitis, and etc. In this paper, the anatomical structure and research progress related to surgical complications were summarized.
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    Comparison of two different decompression procedures for treating large mandibular odontogenic cysts
    WANG Lei, WANG Zhou-yang, MA Chun-yue, WANG Liang, GUO Bing, QIN Xing-jun
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (1): 58-62.   DOI: 10.19438/j.cjoms.2022.01.011
    Abstract640)      PDF (1250KB)(287)      
    PURPOSE: To explore the differences in the prognosis of two different types of decompression procedures for treating large mandibular odontogenic cysts. METHODS: This retrospective cohort study included 93 patients with large mandibular odontogenic cysts, and divided into wall removal group(51 cases) and wall retaining group (42 cases) according to different methods of decompression. Cyst area, volume, HU values and cyst density were compared. The results were analyzed using Prism 7.0 software. RESULTS: After 1 year, the wall removal group was not inferior to the wall retaining group in terms of cyst area, cyst volume, and the difference between the HU values of the original cyst region and the normal mandible. In subgroup analysis, there was no significant difference between the two groups in percentage of patients in whom the cystic area was reduced by 90% after 1 year. However, changes in HU values in the wall removal group were significantly better than those in the wall retaining group. More importantly, patients underwent only one operation in wall removal group if there was no recurrence, which improved the quality of life and reduced the financial burden. CONCLUSIONS: The results suggest that cyst wall removal group showed better results than cyst wall retaining group in large mandibular odontogenic cysts.
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    Prognostic factors of primary intraosseous squamous cell carcinoma: a retrospective review of98consecutive cases
    YANG Jin-gang, XIA Rong-hui, ZHU Yun, WU Si-cheng, DONG Ya-bing, YANG Gong-xin, SHI Jun-long, CUI Ying-hui, ZHU Ling, ZHOU Shang-hui
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 239-243.   DOI: 10.19438/j.cjoms.2022.03.006
    Abstract616)      PDF (529KB)(276)      
    PURPOSE: To delineate the clinical and pathological features and determine the prognostic factors of primary intraosseous squamous cell carcinoma (PIOSCC). METHODS: The clinical, radiological, histopathological and postoperative follow-up data of patients diagnosed with PIOSCC in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from 2013 to 2017 were collected, and the prognostic factors of PIOSCC were analyzed by descriptive statistical methods. Baseline data were analyzed by univariate and multivariate survival analysis with SPSS 23.0 software package. RESULTS: A total of 98 patients with PIOSCC were enrolled, with a mean age of 56.6 years. Among them, there were 71 males and 27 females, and 33 in the maxilla, 65 in the mandible. Of the 95 patients followed up, 24 patients developed local recurrences and 10 patients developed distant metastases; furthermore, most local recurrences and distant metastasis occurred within 2 years after operation. The estimated 2-year and 5-year overall survival were 74.7% and 61.8%, respectively. Univariate analysis showed that tumor site, tumor size, positive margin, and cervical lymph node metastasis were significant prognostic factors for overall survival; facial numbness, positive margin were significant prognostic factors for local recurrences; and tumor site, cervical lymph node metastasis were significant prognostic factors for distant metastasis. Multivariate analysis showed that only positive margin and cervical lymph node metastasis remained as significant prognostic factors for overall survival. CONCLUSIONS: Recurrence, metastasis, and death occurred most frequently within 2 years after operation of PIOSCC. Positive margin and cervical lymph node metastasis were negative prognostic factors for PIOSCC.
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    Comparison of socket-shield technique and routine immediate implantation in anterior maxillary region
    YAO Chen-yang, MEI Dong-mei, TENG Min-hua, Xu Hao, WANG Wen-xue, LI Jing, ZHOU Chen, ZHAO Bao-dong
    China Journal of Oral and Maxillofacial Surgery    2021, 19 (6): 536-541.   DOI: 10.19438/j.cjoms.2021.06.010
    Abstract606)      PDF (1672KB)(250)      
    PURPOSE: To compare the changes in the thickness of labial bone mass and clinical effects between socket-shield technique and routine immediate implant placement in the aesthetic area of anterior maxillary region, and discuss operation details of the socket-shield technique. METHODS: Forty-eight patients were included for immediate implantation between September 2017 to March 2019 in the Affiliated Hospital of Qingdao University. Of them, twenty-six patients underwent routine immediate implantation(RI group), while 22 patients received socket-shield technique(SS group). The follow-up periods were 18-36 months, and the following parameters were employed for comparison: implant success rate, the changes of labial bone plate at 0 mm (I0), 3 mm (I3) and 6 mm (I6) below the shoulder of the implant, the pink aesthetics index(PES) at the last follow-up, gingival sulcus bleeding index and clinical satisfaction. SPSS 25. 0 software package was used for data analysis. RESULTS: The success rate in both groups was 100%. At 6 months and 18 months after operation , the changes of labial bone plate in SS group were lower than those in RI group, with significant difference at I0 and I3. PES score in SS group was higher than that in RI group, but with no significant difference. There was no significant difference in the modified sulcus bleeding index between these two techniques, and both groups obtained high patient satisfaction. CONCLUSIONS: Compared with routine immediate implantation, socket-shield technique maintains bone mass in the labial side of the neck of the implant and soft tissue profile in a short period of time, but has no obvious effect on the success rate. However, these two methods still need long-term clinical observation. It is recommended to prepare root film to the level of the bone surface, with a thickness of about 1 mm,keep a gap of about 1-2 mm on the labial side of the implant and then fill the bone graft material into the defect site. Pitifully, this technique needs highly difficult requirement of clinical procedure.
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    Case report of parotid, submandibular lymph node metastasis of ocular sebaceous gland carcinoma
    FU Hong-hai, QIU Na-na, SUN Le-gang, WANG Fang
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (3): 307-309.   DOI: 10.19438/j.cjoms.2022.03.019
    Abstract596)      PDF (894KB)(119)      
    Ocular sebaceous gland carcinoma usually occurs in the upper eyelid, and metastasis to the parotid gland and submandibular lymph node is rare. Therefore, it is necessary to differentiate it from the primary parotid gland tumor in clinical practice. In this paper, we reported a case of ocular sebaceous gland carcinoma of the upper eyelid with metastasis to the parotid and submandibular lymph nodes, providing clinical guidance for the diagnosis and treatment of this disease.
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    Comparison of reliability of 5 evaluation methods for intraoral tonsil hypertrophy in awake and anesthetized individuals
    YAO Kan, XIE Yi-lun, YU Wen-wen, WEI Si-long, XIA Liang, ZHENG Tong, LU Xiao-feng
    China Journal of Oral and Maxillofacial Surgery    2022, 20 (5): 461-465.   DOI: 10.19438/j.cjoms.2022.05.008
    Abstract569)      PDF (861KB)(226)      
    PURPOSE: To determine the reliability of the 5 clinical grading scales of tonsillar size in reporting the size of tonsils in awake and anesthetized individuals. METHODS: Awake and anesthetized tonsillar images of 218 patients aged 3 to 14 years with no severe craniofacial abnormalities were retrospectively collected. For each patient, five separate tonsil assessments were conducted by 3 experienced experts. Intraclass correlation coefficients(ICC) and Cronbach's α were used to determine the reliability of tonsil size in awake and anesthetized state. Statistical analysis was performed with R language (version 3.6.3). RESULTS: The reliability was highest for traditional 3-grade scale (ICC, 0.58; Cronbach's α, 0.74), followed by Friedman grading scale (ICC, 0.57; Cronbach's α, 0.73), modified 3-grade scale (ICC, 0.57; Cronbach's α, 0.72), modified 5-grade scale(ICC, 0.42; Cronbach's α, 0.59) and Brodsky grading scale(ICC, 0.30; Cronbach's α, 0.46). CONCLUSIONS: The tonsils tended to be underestimated when the individuals were awake, while the 5 tonsil assessments were able to figure out the real volume of tonsils respectively.
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