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20 January 2016, Volume 14 Issue 1 Previous Issue    Next Issue

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Enhanced osteogenesis in peri-implant through local hOPG transfection LI Jia-yang, YIN Guo-zhu, SUN Yue, CHEN Gui-zhen, JI Huan-zhong, LUO En 2016, 14 (1):  1-7.  Abstract ( 338 )   HTML ( 0 )   PURPOSE : To study the role of local stable expression of OPG in peri-implant in bone regeneration during repair process. METHODS : Sixty-six SD rats were divided into A, B and C group randomly. In group A, adenovirus-hOPG-EGFP was injected around the implant; in group B, adenovirus-EGFP was injected around the implant; in group C, same volume of PBS was injected in the periphery of implant. The animals were sacrificed 1 week, 4 weeks after operation, and the femur bone containing the implant was collected. Micro-CT, H-E staining, toluidine blue staining were used to observe new bone formation. The data was analyzed with SPSS 15.0 software package. RESULTS : A successful vector of reconstructed adenovirus- OPG-GFP as gene therapy was established. In vitro the GFP was successfully expressed in the BMSCs of SD rats. At 4 weeks after implant surgery, osteointegration was observed in all groups. However, % BIC, % bone area, BV/TV, % OI, Tb.N, Tb.Th, Conn.D in the peri-implant area in group A significantly increased compared with the control group (B and C)(P<0.05). Tb.Sp was also significantly less in experimental group (A) than that in control group (B and C). CONCLUSIONS : Local hOPG transfection can be successfully conducted, and the stable expression of protein OPG in peri-implant area can remarkably promote osteogenesis. References | Related Articles | Metrics

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Studies on navigation mandibular distractor in mandible distraction osteogenesis in goats XU Lei, CAI Ming, YU Wen-wen, SUN Hong-xia, WANG Meng, YAO Kan, CAI Qi-xun, WEI Si-long, LU Xiao-feng 2016, 14 (1):  8-13.  Abstract ( 347 )   HTML ( 2 )   PURPOSE S: To investigate the accuracy of navigation-guided mandibular distraction ostergenesis (DO) on animal model by using TBNavis-CMFS navigation system with navigation mandibular distractors. METHODS : Five registration screws were implanted in the mandible of 4 goats under general anesthesia before scanned by computerized tomographic (CT). CT data and 3D image of navigation mandibular distractors were imported in Surgicase 5.0 and TBNavis-CMFS to design the surgery plan and predict the outcomes. Four goats were divided into 2 groups, goats in group 1 were implemented with mandibular angle osteotomy, while goats in group 2 were implemented with mandibular ramus osteotomy. Paired t test was carried out using SPSS 17.0 software package. RESULTS : With the use of navigation mandibular distractors, there was no significant difference between 3D models and real objects in size parameters (P>0.05). Mean distractor axel angle of virtual and navigated operation was 2.45° (1.56°~3.69°), mean osteotomy plane angle of virtual and navigated operation was 1.53° (1.16°~3.25°). There was no significant difference between ipsilateral condyle distance to the osteotomy plane of virtual and navigated operation (P>0.05). CONCLUSIONS : Navigation-guided mandibular DO with navigation mandibular distractors is able to transfer the pre-surgical planning to realtime surgery precisely, which can be used for mandibular DO under navigation environment clinically in future. References | Related Articles | Metrics

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3D-measurement of temporomandibular joint morphology and preliminary use in osteoarthritis BAI Guo, HE Dong-mei, YANG Chi, ZHANG Lu-zhu, WANG Fei-yu, DONG Min-jun, CHANG Yu-si 2016, 14 (1):  14-18.  Abstract ( 414 )   HTML ( 4 )   PURPOSE : To establish a new 3D-measurement method of temporomandibular joint (TMJ) and make comparison of TMJ osseous morphology of the affected and contralateral side in patients with unilateral osteoarthritis, and preliminarily study TMJ osseous remodeling of the affected side. METHODS : Patients who were diagnosed with unilateral TMJ osteoarthritis and needed total replacement surgery from Mar. 2005 to Dec. 2014 were included in this study. Physical examination and TMJ magnetic resonance image (MRI) were taken to ensure the contralateral joint was healthy. Cranial-maxillofacial computed tomography (CT) of each patient was taken and imported into Proplan CMF 1.4 software to reconstruct the skull and a new 3D-measurement method of TMJ osseous morphology was established. Paired t test was used to evaluate the difference between the affected and contralateral side in patients with unilateral osteoarthritis using SAS 6.1 software package. RESULTS : The lateral depth of glenoid fossa, the sagittal diameter of condyle, the height condylar head, the width of zygomatic arch and the length of ramus on the affected side were significantly different from the contralateral side (P<0.05). However, the medially inclining angle of condyle, the retrally leaning angle of condyle, the sagittal diameter and horizontal diameter of glenoid fossa, the anterior slope angle of glenoid fossa, the height of articular eminence, the thickness of zygomatic arch, the width of anterior and posterior slope of condyle, the sagittal diameters of condyle and condylar neck on the affected side all showed no significant differences from the contralateral side (P>0.05). CONCLUSIONS : The 3D-measurement method of osseous morphology of TMJ was built, which provided the anatomy reference for design of TMJ prosthesis. The preliminary RESULTS of comparison between the affected and contralateral side in unilateral osteoarthritis patients showed that the affected side had a relatively flat glenoid fossa and less condylar head height as well as ramus length than the healthy side. References | Related Articles | Metrics

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Early stability of Straumann implants on osteotome sinus floor elevation without bone grafting MO Jia-ji, QIAN Shu-jiao, ZHU Yu, QIAO Shi-chong, GU Ying-xin, LAI Hong-chang 2016, 14 (1):  19-23.  Abstract ( 492 )   HTML ( 6 )   PURPOSE : To monitor the stability changes of Straumann implants placed by osteotome sinus floor elevation without grafting (OSFE without grafting) using resonance frequency analysis (RFA) during healing period, and analyses the effect of residual bone height on RFA. METHODS : Forty-eight Straumann implants ( 4.8 mm×8 mm) were placed in 48 patients with single tooth lost. Implant stability quotient (ISQ) was tested by RFA on the day of surgery and consecutively at 2, 4, 6, 8 ,12, 16 and 20 weeks after surgery. The data were analyzed using SPSS 17.0 software package. RESULTS : 97.9% survival rate was achieved in 48 implants and all implants had good primary stability at early stage. The mean ISQ value on the day of surgery was high and dropped to the lowest point at 4 weeks after surgery, then increased after 6 weeks in the stability curve. There was no significant correlation between residual bone height and ISQ value. CONCLUSIONS : Implant using OSFE placed at limited bone areas seems to have good implant stability. The RBH is not the main influential factor on implant stability. References | Related Articles | Metrics

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Radiological follow-up results of untreated anterior disc displacement without reduction in adolescents ZHUO Zi-ang, CAI Xie-yi 2016, 14 (1):  24-27.  Abstract ( 581 )   HTML ( 5 )   PURPOSE : To assess radiographic progression in adolescents with anterior disc displacement without reduction (ADDWoR) without treatment using serial MRI. METHODS : A retrospective review was conducted in patients under 20 years of age with unilateral ADDWoR who underwent MRI examination twice over 6 months without any intervention between January 2010 and June 2013. On MRI, bone changes ,disc deformation and effusion were evaluated. SAS 9.13 software package was used for statistical analysis. RESULTS : One hundred and twenty-two patients (101 females, 23 males) with a mean age of 16.4 years underwent MRI examination twice at least 6 months apart (mean: 13.6 months). At initial visit, there was significant difference between the involved and the non-involved side in condylar degeneration and effusion. Following no intervention, the frequency of effusion significantly decreased, the frequency of disc deformation significantly increased, and the frequency of condylar degeneration increased from 60.48% to 69.36% without significant difference. CONCLUSIONS : During the period of clinical observation, there was significant decrease in effusion and significant increase in disc deformation. Whilst there was an increase in condylar surface change, but without significant difference. References | Related Articles | Metrics

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Retrospective analysis of 133 patients with oral and maxillofacial space infection in Xinjiang region GUO Zhi-chen, GONG Zhong-cheng, LIN Zhao-quan, LING Bin, LIU Hui, KARMESH Bajracharya 2016, 14 (1):  28-32.  Abstract ( 407 )   HTML ( 4 )   PURPOSE : A retrospective study on the characteristics of patient, clinical symptoms, etiology of oral and maxillofacial space infection and involved spaces, treatment and complications in Xinjiang Uygur Autonomous Region was carried out, in order to identify factors predisposing to life-threatening complications and provide references for prevention of complications. METHODS : The clinical data of 133 patients with oral and maxillofacial infection treated in the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed from May 2013 to May 2015.Univariate analysis and multivariate analysis were done for identifying associations of patient characteristics with complications by SPSS 16.0 software package. RESULTS : Out of 133 patients identified, 52.6% were male, 47.4% were female. The average interval time from presence of symptoms to hospitalization was 23.8 days. The mean age of patients was 45.9 years and 35.3% of the patients had diabetes. The most common odontogenic infection was periapical periodontitis. Thirty-five (26.3%) patients had pupal infection. The most commonly involved space was massteric space. In non-odontogenic infection, the most common origin was glandular infection with 15 cases(11.2%). The most commonly involved space was submental space. Twenty two patients (16.5%) developed complications. Multiple space involvement and leukocyte count≥15×109/L were independent predictors of complications. CONCLUSIONS : Patients with oral and maxillofacial space infection who present multiple space involvement, a high leukocyte count, and those with diabetes are the higher risk factors of developing life-threatening complications and need to be closely monitored. References | Related Articles | Metrics

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Comparison of temporomandibular joint reconstruction with free coronoid process graft and costochondral graft in the treatment of temporomandibular joint ankylosis HUANG Dong, HE Dong-mei, YANG Chi, LU Chuan, BAI Guo 2016, 14 (1):  33-38.  Abstract ( 443 )   HTML ( 3 )   PURPOSE : To compare the effect of free coronoid process graft (CPG) and costochondral graft (CCG) in the treatment of temporomandibular joint ankylosis (TMJA). METHODS : Ten TMJA patients (15 joints) treated with CPG or CCG in our department from 2011 to 2014 were included in this study. All patients were followed up for more than 6 months after operation. Post operative CT scan data within 1 week after operation and during follow up were imported into the Proplan CMF 1.4 software (Materialize, Belgium) for 3 dimensional reconstruction and measurement. Bone absorption was measured and compared between the 2 METHODS using paired t test with SPSS 19.0 software package. Maximum mouth opening (MMO) and occlusion were also evaluated and compared before and after operation. RESULTS : In CPG group, the average follow-up duration was 16.8 months (ranged from 6-22 months). The average bone absorption was 5.41 mm (21.9% of the initial height). Tip of the grafted bone was reformed to be round. The average MMO was 31.6mm, which had significant difference between the preoperative values (P<0.05). Four of 5 patients developed open bite, one patient had TMJA recurrence. In CCG group, the average follow-up duration was 14.4 months (ranged from 6~30 months). The average bone absorption was 2.44 mm (6.2% of the initial height). The average MMO was 33.6 mm, which had a significant difference between the preoperative values (P<0.05). One of 5 patients developed open bite, the other 4 patients had stable occlusion. No patient had recurrence. CONCLUSIONS : In the treatment of TMJA, bony absorption rate in CPG patients was higher than that in CCG patients, which was easy to cause occlusion changes. References | Related Articles | Metrics

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Surgical strategies to secondary head neck reconstruction after previous operations with or without radiotherapy XU Zhong-fei, DUAN Wei-yi, BAI Shuang, TIAN Yu, TAN Xue-xin, SUN Chang-fu, LIU Fa-yu, DAI Wei 2016, 14 (1):  39-43.  Abstract ( 409 )   HTML ( 2 )   PURPOSE : To discuss the surgical strategies to secondary free tissue transfer after previous operations with or without radiotherapy in head and neck reconstruction. METHODS : Between January 2012 and December 2014, secondary head and neck reconstruction was performed in 13 patients who had undergone previous neck dissection (n=12) and radiation therapy (n=11). All secondary defects were reconstructed with free flaps. Clinical data were recorded for each patient. RESULTS : Nine patients had a recurrent carcinoma, two had a secondary primary cancer, one had undergone an operation for scar release and one had an osteoradionecrosis of mandible after radiotherapy for nasopharyngeal carcinoma. All free flaps survived well and the patients healed without major complications. Anterolateral thigh flap (ALT, n=7), anteromedial thigh flap (AMT, n=1), radial forearm free flap (n=1), fibular flap (n=2) and ALT+AMT flaps (n=2) were used for reconstruction. Transverse cervical vessels (TCVs, n=10), vessels of contra-lateral neck (n=2) and superficial temporal vessels (STV, n=1) were chosen as recipient vessels. The mean follow-up time was 11 months. One patient died of distant metastases and 1 died of local recurrence during follow-up. CONCLUSIONS : In patients who had previously undergone neck surgery with or without radiotherapy, the TCVs are reliable and accessible recipient vessels for microsurgical reconstruction in the head and neck region. If the TCVs are unavailable, the STVs and the vessels of contra-lateral neck can serve as an alternative for microvascular anastomosis. Additionally, the internal or external jugular vein should be dissected carefully to avoid vein grafting. References | Related Articles | Metrics

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Computer assisted navigation for craniofacial fibrous dysplasia contouring: retrospective study in 33 consecutive cases XIAO Chao, DAI Jie-wen, ZHANG Wen-bin, WU Jin-yang, SHEN Shun-yao, SHEN Guo-fang 2016, 14 (1):  44-50.  Abstract ( 419 )   HTML ( 5 )   PURPOSE : To evaluate the effect of computer assisted navigation system (CANS) in contouring of craniomaxillofacial fibrous dysplasia (CFD). METHODS : Thirty-three patients with craniomaxillofacial fibrous dysplasia were included in this study for surgical contouring from January 2010 to December 2013. The patients were divided into 2 groups based on the treatment METHODS. The experimental group included 17 patients who had preoperative virtual surgery design, and underwent surgery with the help of computer assisted navigation system. The control group included 16 patients who underwent surgery without the help of computer assisted navigation system. Each patient underwent computed tomography scans in craniomaxillofacial region 1 week and 3 months after surgery. We measured the models using Geomagic Qualify software. Quantitative evaluation of the effects in both groups was performed using SAS 6.2 software package for student’s t test. RESULTS : In navigation group, mean variation between operative region and preoperative design was (2.1400±1.2482) mm. With mirror model as reference, mean variation of operative region was (2.1285±1.2957) mm in navigation group, whereas (4.4814±2.1940) mm in non-navigation group, there was significantly difference between the 2 groups. CONCLUSIONS : CANS might be more useful in improving the precision in contouring of craniomaxillofacial fibrous dysplasia than conventional METHODS. References | Related Articles | Metrics

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Risk factors of inferior alveolar nerve and vessels injury in the mandibular third molar extractions: the contact and positional relation between root and inferior alveolar canal YE Zhou-xi, YANG Chi 2016, 14 (1):  51-56.  Abstract ( 593 )   HTML ( 6 )   PURPOSE : To suggest a risk degree and classification according to the contact and positional relation between root and inferior alveolar canal (IAC) for prognosis estimation and surgery design. METHODS : Consecutive cases with complicated mandibular third molars underwent extraction using piezosurgery were reviewed. Those teeth contacted IAC in panoramic radiographs were included, and classified into degree Ⅰ (contact), Ⅱ (compress), Ⅲ (penetrate) according to the contact relation between root and IAC in both panoramic radiographs and cone-beam CT (CBCT). Kappa test and youden index were used to compare two imaging RESULTS. The included teeth were categorized into class I (root on the buccal side), Ⅱ (above IAC), Ⅲ (on the lingual side), Ⅳ (surrounding IAC) according to the positional relation. Inferior alveolar nerve and vessels injury rates of teeth in different degrees and categories were recorded. Fisher’s exact probability was used to analyze the difference of injury rates in teeth of different degrees and categories. Statistical analysis was performed using SAS 8.2 software package. RESULTS : 79.31% (92/116) of complicated mandibular third molars had inferior alveolar nerve and vessels injury risk (33.70%, 28.26%, 38.04% in risk degree Ⅰ, Ⅱ, Ⅲ according to the evaluation of panoramic radiographs, 36.96%, 33.70%, 29.35% in risk degree Ⅰ, Ⅱ, Ⅲ according to CBCT). The concordance of two images RESULTS was better on Kappa test (Kappa=0.8699). Teeth in risk degree Ⅰ, Ⅱ were occasionally mistaken for Ⅲ in panoramic radiographs. The percentages of teeth in class Ⅰ, Ⅱ, Ⅲ and Ⅳ were 31.52%, 55.43%, 11.96% and 1.09%. 7.61% (7/92) of teeth developing inferior alveolar nerve and vessels injuries during extractions (3 in degree Ⅲ class Ⅲ, and 2 in degree Ⅲ class Ⅱ, 2 in degree Ⅱ class Ⅱ). Teeth in higher risk degrees had higher percentage to injure inferior alveolar nerve and vessels (P<0.05). The injury rate was highest in teeth whose roots were on the buccal side of IAC (P<0.05). CONCLUSIONS : Panoramic radiographs could evaluate the contact relation between root and IAC. CBCT can overcome the limitation of overlapping structures and provide positional relation. Extractions of teeth in degree Ⅱ or Ⅲ and class Ⅱ or Ⅲ are easier to cause inferior alveolar nerve and vessels injuries. Direct force should be avoided during extraction. References | Related Articles | Metrics

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Recent clinical observation of the effect of cyclic bone grafting combined with dental implant technology ZHENG Qiao-yi, CHEN Jue-yao, CHEN Jun-lan 2016, 14 (1):  57-61.  Abstract ( 380 )   HTML ( 0 )   PURPOSE : To evaluate the short term clinical outcomes of bone ring in severe alveolar bone absorption patients. METHODS : From June 2012 to December 2013, twenty-one patients with severe alveolar bone absorption received implant placement with bone ring technique. CT scanning was taken before surgery and 5 months after implantation. The alveolar bone height, sagittal bone absorption and gingiva changes were measured 3 months after final restoration. The data were analyzed with SPSS 17.0 software package. RESULTS : Postoperative healing was uneventful in 20 patients while 1 implant lost due to bone ring infection, the survival rate was 95.24%. The alveolar bone height increased (6.74±2.31) mm, while the bone absorbed (2.62±1.66) mm. The sagittal bone thickness was (7.53±0.73) mm. Lingual and labial bone loss was (2.81±1.05) mm and (2.46±0.92) mm, respectively, the difference was not statistically significant (P>0.05). The PD value of implant was (1.76±0.41) mm and the adjacent tooth (1.70±0.33) mm, the difference was not statistically significant (P>0.05). No significant complication occurred. All patients were satisfied with the surgery. CONCLUSIONS : The bone ring technique in severe alveolar bone absorption patients is reliable and relatively simple. References | Related Articles | Metrics

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Study of controlled hypotension by dexmedetomidine in orthognathic surgery ZHANG Ling, ZHU Ying 2016, 14 (1):  62-65.  Abstract ( 328 )   HTML ( 3 )   PURPOSE : To observe the effect and safety of controlled hypotension by dexmedetomidine in oral maxillofacial orthognathic surgery. METHODS : Forty patients undergoing orthognathic surgery were randomly divided into 2 groups: group D received dexmedetomidine (n=20), group NS received normal saline (n=20).After induction before the operation, dexmedetomidine 1.0 μg/kg was given intravenously within 10 min, then maintained at 0.5 μg/(kg·h) in group D, the same maintained speed of normal saline was given in group NS .Both groups were combined with propofol, remi-fentanyl, sevoflurane for controlled hypotension. The target MAP was maintained at 50-65 mmHg. HR, SBP, DBP and MAP were recorded before anesthesia and during the phase of controlled hypotension. And the dosage of propofol and remi-fentanyl in both groups was compared; meanwhile, the scores of surgical field quality (SSFQ) were assessed according to Fromme surgical field quality list. SPSS 11.0 software package was used for comparison of the 2 groups. RESULTS : During controlled hypotension ,MAP in both groups were significantly lower than those before anesthesia (P<0.01). MAP and HR in group D at T3(at the beginning of surgery), T4(15 min after surgery ), T5( 30 min after surgery) were significantly lower than that of group NS (P<0.05). HR in group NS at T3, T4, T5, and T6(60 min after surgery) were significantly higher than those before anesthesia (P<0.05). The dosage of propofol in group D was significantly lower than that in group NS (P<0.05). Compared with group NS, surgical field quality in group D were significantly better (P<0.05). CONCLUSIONS : Dexmedetomidine can be used safely and efficiently for controlled hypotension in oral maxillofacial orthognathic surgery, combined use of dexmedetomidine can avoid fluctuation in blood pressure and heart rate, make the hemodynamics more stable, and reduce the dosage of propofol, and achieve better surgical field quality. References | Related Articles | Metrics

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Application of improved condylectomy in adult intracapsular fracture of mandibular condyle WANG Fan, YANG Qing-fu 2016, 14 (1):  66-68.  Abstract ( 384 )   HTML ( 1 )   PURPOSE : To evaluate the application of improved condylectomy in adult intracapsular fracture of mandibular condyle. METHODS : Thirty-three adult patients with intracapsular fracture of mandibular condyle were treated by improved condylectomy, assisted by appropriate intermaxillary traction and mouth opening exercise after operation. RESULTS : More than 80% patients had normal occlusion, and the mouth opening reached over 35 mm 6 months after operation; no permanent facial nerve palsy and ankylosis were noted. CONCLUSIONS : Improved condylectomy is simple and fits in primary hospital, but has strict indication; appropriate selection of indication is the key to success. References | Related Articles | Metrics

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Assessing the consciousness change after severe craniomaxillofacial injury with GCS-M scale ZHAO Yan, GUO Zhi-lin 2016, 14 (1):  69-71.  Abstract ( 305 )   HTML ( 1 )   PURPOSE : To estimate the ability of GCS-M to judge the change of consciousness in severe craniomaxillofacial injury patients. METHODS : Sixty-three patients with severe craniomaxillofacial injury were retrospectively reviewed based on their GCS-M scale and CT scan. Statistical analysis was undertaken with SPSS 14.0 software package. RESULTS : Among 63 cases, there were 17 cases with 4 of GCS-M at admission and 18 cases with 3 of GCS-M. Of 17 cases , eight cases became worse, their GCS-M scale decreased to 3, and CT scan showed that the intracranial hematoma became larger and then received surgery. After operation, the GCS scale of these 8 cases recovered to 4. All 18 cases with 3 of GCS-M underwent operation because large intracranial hematoma volume or dislocation of the midline; after operation, their GCS-M scale increased to 4. Statistical analysis demonstrated that the relation of GCS-M with intracranial hematoma volume was negative. CONCLUSIONS : GCS could correctly assess the consciousness of head injury, but sometime it is not possible to use GCS to estimate the consciousness of craniomaxillofacial injury such as periorbital injury with which the patient could not open the eye. GCS-M scale could compensate GCS. When GCS-M scale decreases, consciousness of patients would become worse. References | Related Articles | Metrics

Clinical Reports

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A clinical analysis of impacted teeth in 37 elder patients HU Ying-kai, XU Guang-zhou, YANG Chi 2016, 14 (1):  72-75.  Abstract ( 414 )   HTML ( 3 )   PURPOSE : To analyze the clinical characteristics of impacted teeth in the elderly and provide reference for diagnosis and treatment of them. METHODS : Thirty-seven patients including 17 males and 20 females whose ages ranged from 58 to 82 years were referred to our department from 2010 to 2014. Most of them were associated with systemic diseases. After taking pantomograms and computed tomograms and evaluation of systemic condition, the patients underwent extraction of impacted teeth with different METHODS. The position and impacted type of each tooth, as well as associated lesions were recorded and analyzed. RESULTS : Of all the impacted teeth, mandibular third molars accounted for 80%, of which horizontal and inverted impaction types were mostly seen. Maxillary third molars and supernumerary teeth accounted for 13.3% and 6.7%, respectively. Dentigerous cysts were found in 7 teeth and 5 teeth were accompanied by local osteomyelitis. CONCLUSIONS : Extraction of impacted teeth in elder patients should be performed gently with minor injury after adequate preparation and full evaluation. Elective extraction of impacted teeth was proposed for elder patients when the impaction depth was less than 2 mm, in order to reduce the incidence of pericoronitis, cysts or infection. References | Related Articles | Metrics

Review

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The treatment of osseous defect distal to the mandibular second molars following surgical removal of impacted mandibular third molars: a literature review GE Jing, YANG Chi, ZHENG Jia-wei, WANG Yong 2016, 14 (1):  76-82.  Abstract ( 433 )   HTML ( 22 )   The presence of osseous defect distal to the mandibular second molars as a result of surgical removal of impacted mandibular third molars is a common phenomenon, and the management is often far from easy. The nature course of the periodontal breakdown suggested patients with high risk indicators should be intervened at the time of tooth removal. Compared to periodontal treatment and placing membranes, dentoalveolar reconstructive procedures exhibit a more effective outcome in inducing and accelerating bone regeneration. The bone graft substitutes include autogenous bone, allograft bone, synthetic bone and tissue engineered bone. Although the use of various biomaterials have made significant progress in bone regeneration, total bone regeneration still needs to be investigated. References | Related Articles | Metrics

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Research progress of the relationship between COX-2 and bone formation MA Wu-di, XIA Lun-guo, ZHOU Yu-ning, XU Yuan-jin 2016, 14 (1):  83-88.  Abstract ( 630 )   HTML ( 12 )   Cyclooxygenase-2 (COX-2) is the rate-limiting enzyme of arachidonic acid (AA) synthesizing prostaglandin E2 (PGE2). It has various effects on bone metabolism that stimulate both bone resorption and formation through regulation of PGE2. Meanwhile, COX-2 can work by the participation of multiple signal transduction pathways in bone formation, including Gαs signaling pathway, mitogen-activated protein kinases (MAPKs) pathway and receptor activator of nuclear factor κB ligand (RANKL) signaling pathway. COX-2 was induced by many factors, and can be inhibited by the inhibitors such as non-steroidal anti-inflammatory drugs (NSAIDs). These factors can regulate the production of COX-2 and consequently have impact on bone tissue. The main PURPOSE of the article was to introduce the relationship between COX-2 and bone formation and its potential clinical applications. References | Related Articles | Metrics

Case Reports

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Mandibular reconstruction in patients with familial gigantiform cementoma: report of 2 cases and review of the literature WANG Hong-wei, MA Chun-yue, HE Guang, XU Li-qun, ZHANG Chen-ping, QIN Xing-jun 2016, 14 (1):  89-92.  Abstract ( 448 )   HTML ( 2 )   Familial gigantiform cementoma (FGC) is a rare autosomal dominant, benign fibro-cementoosseous lesion that is generally limited to the facial bones, typically in the anterior portion of the mandible. The treatment remains extensive resection with reconstruction of the osseous defect to provide aesthetic and functional rehabilitation. However, patients with FGC often have concomitant long bone abnormalities and pubertal pathologic fractures. In addition, FGC always presents in the first or second decades. Therefore, the choice of bone reconstruction warrants extreme caution. Literatures regarding the treatment of such patients are limited. This paper reported 2 patients with FGC treated at our hospital. Postoperative appearance, oral function and radiographic images were evaluated. The treatment experience was summarized based on review of relevant literatures. References | Related Articles | Metrics

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Teratoma in the parapharyngeal space of infant：a case report and literature review WU Yu-ling, ZHAO Xiao-peng, TANG Dong-xiao, PAN Chao-bin 2016, 14 (1):  93-96.  Abstract ( 365 )   HTML ( 1 )   Teratomas is a rare category of neoplasm that arises from all three embryonic germ layers, while head and neck teratoma is even more unusual. Because clinical diagnosis is difficult, accumulation of case series and experiences is necessary. This article reported an unique case of teratoma in parapharyngeal space in a 3-month-old boy who also had congenital cleft palate. Clinical manifestations, pathological findings and treatment were presented along with brief review of literature. References | Related Articles | Metrics