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20 May 2018, Volume 16 Issue 3 Previous Issue    Next Issue

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Resection of mandibular benign tumors by transoral approach and use of intraoral microvascular anastomosis for segmental mandibular reconstruction with vascularized fibula osseous flap: a pilot study in 4 consecutive patients SUN Jian, SHEN Yi, LV Ming-ming, LI Feng, WANG Hui-shan, BAI Shi-zhu, WANG Liang, YANG Xin, LI Jun. 2018, 16 (3):  193-198.  doi: 10.19438/j.cjoms.2018.03.001 Abstract ( 860 )   PURPOSE: To introduce our experience in transoral segmental mandibulectomy of benign tumor and intraoral microvascular anastomosis for mandibular reconstruction with vascularized fibula osseous flap. METHODS: Between January and March 2018, transoral segmental mandibulectomy of benign tumor and intraoral microvascular anastomosis for mandibular reconstruction with vascularized fibula osseous flap were performed in 4 patients in our department. Preoperative virtual surgical planning, prebending of reconstruction plate and intraoperative navigation for confirmation of neomandibular site were performed in 3 patients. Facial artery and vein were exposed to protect at intraoral buccal region prior to segmental mandibulectomy and shaping of grafted fibula. Intraoral microvascular anastomosis of facial artery and peroneal artery in an end-to-end fashion, whereas facial vein and peroneal vein in an end-to-end fashion with the Coupler. Conventional postoperative monitoring of blood flow signal was conducted with hand-held ultrasound doppler. Panoramic radiographs were taken to assess the neomandible on day 7 postoperatively. RESULTS: Successful transoral segmental mandibulectomy was completed in 4 patients and intraoral microvascular anastomosis for mandibular reconstruction with vascularized fibula osseous flap was completed in 3 patients. Microvascular anastomosis at submandibular region was done in another patient because intraoral facial vein was not suitable. Normal blood flow signal was displayed on hand-held ultrasound Doppler. Intraoral and donor site wounds were healed uneventfully. Ideal neomandible and good occlusion were observed in postoperative panoramic radiographs. Symmetric facial appearance and no restriction of mouth opening were achieved in all patients. All patients were satisfied with the surgical results. CONCLUSIONS: It is feasible to avoid extraoral incision by transoral segmental mandibulectomy of benign tumor and intraoral microvascular anastomosis for mandibular reconstruction with vascularized fibula osseous flap. The same postoperative results of transoral approach as that of extraoral approach can be achieved. References | Related Articles | Metrics

Original Articles

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Effect of GRGDSP peptide coating on pure titanium surface on osteointegration DENG Yun-long, LI De-chao, LI Mu-qin, JIAO Yu-feng, ZHANG Hui-ming, ZHANG Guo-liang, ZHANG Zhou-ming. 2018, 16 (3):  199-204.  doi: 10.19438/j.cjoms.2018.03.002 Abstract ( 370 )   PURPOSE: Micro-arc oxidation (MAO) of titanium alloy was implemented, then GRGDSP polypeptide was loaded by coupling of dopamine (PDA) to form a composite active coating，in order to enhance esteointegration. METHODS: Eighteen adult New Zealand white rabbits were selected to establish a unilateral mandibular model. Ti-MAO (group A), Ti-MAO-PDA (group B) and Ti-MAO-PDA-GRGDSP (group C) were implanted into the mandible of rabbits. The mandibular bone on one side was selected at 2, 4, 8 weeks to harvest sample. Bone allografts were observed on cone-beam CT (CBCT). The interface of sample at 4w was observed under scanning electron microscopy (SEM), laser scanning confocal microscope was used to observe the degree of osteoblast activity, torsion test was applied to observe osseointegration. The date were compared between groups with one-way ANOVA using SPSS19.0 software package. RESULTS: For osseointegration at contact region, group C was better than group A and group B, and group B was better than group A on CBCT. SEM showed that group C had more new bone aggregated in the contact area between implant and bone. Laser confocal microscopy showed that the fluorescence intensity of group C was significantly higher than that of group B at the junction. The torsional force of group B and C at 8w was 2 times of that of group A, and group C was 8 N·cm greater than group B. The difference was statistically significant between group C and group B, comparing to group A(P<0.05). CONCLUSIONS: Ti-MAO-PDA and Ti-MAO-PDA-GRGDSP coatings can promote osseointegration, of which Ti-MAO-PDA-GRGDSP coating has the strongest osseointegration effect. References | Related Articles | Metrics

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Evaluation of the application value of cervical lymphatic imaging of the tongue interstitial magnetic resonance lymphography by submucosal injection of C/Gd nanocomposite SHAN Jun, ZENG Wen-xia, LIU Shi-en, XU Hao-yue, ZHU Hai-tao, SONG Kai, FENG Yuan-yong, WU Da-xiong, SHANG Wei. 2018, 16 (3):  205-208.  doi: 10.19438/j.cjoms.2018.03.003 Abstract ( 341 )   PURPOSE: To investigate the application value of cervical lymphatic imaging enhanced by submucosal injection of C/Gd nanocomposite as a new lymphoid contrast agent in interstitial magnetic resonance lymphography (IMRLG). METHODS: 0.2 mL C/Gd nanocomposite was injected into the bilateral tongue submucosa in 12 healthy New Zealand white rabbits and then massaged the injection site for 30 s. MR images were obtained before injection and 5,10,15,20 and 40 mins after injection by using 3D enhancement magnetic resonance lymphography. The signal intensities were measured to calculate the enhancing rates (E%) and the signal enhancing rates-time curve was drawn before and after enhancing of cervical lymph nodes. The data were statistically analyzed by using SPSS17.0 software package. RESULTS: After injection, C/Gd nanocomposite was rapidly absorbed into the cervical drainage area. The lymph nodes and lymphatic vessels were strengthened significantly; however, the blood vessels were not displayed at the same time. The enhancing rates of the cervical lymph nodes reached a peak 10 mins after injection, and the best enhancing effect was between 5 mins and 20 mins. It would not be able to distinguish from that of the surrounding tissues. CONCLUSIONS: As an IMRLG contrast agent, C/Gd nanocomposite can characteristically display the cervical lymph node morphology and lymphatic shape effectively with a small dose. References | Related Articles | Metrics

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Expression of HIF-1α and Notch-1 induced by hypoxia after ischemia reperfusion injury in tissue flap LI De-long, NIU Qi-fang, FENG Zhi-en, SU Ming, OUYANG Jia-jie, YANG Yang, LI Jin-zhong, XU Qiao-shi, HAN Zheng-xue. 2018, 16 (3):  209-214.  doi: 10.19438/j.cjoms.2018.03.004 Abstract ( 424 )   PURPOSE: To observe the expression of HIF-1α-Notch signaling pathway after ischemic-reperfusion injury. METHODS: Twenty-four Wistar Rats were randomly divided into blank group(4 mice), sham group(4 mice) and ischemic-reperfusion （I/R） group (16 mice). The rats of both sham group and IR group were operated to make a 4cm×8cm flap on the left abdomina, then the flaps of IR groups suffered from 6 hours of postoperative ischemia. Four rats were executed each time immediately and the 1st, the 3rd , the 7th day after operation, and the tissue samples in I/R groups were collected. The rats in sham group and blank group were executed at the 7th day and tissue samples were collected. mRNA expression levels of HIF-1α, Notch-1 were detected by RT-PCR and protein expression levels were detected by Western blot in I/R group, sham group and blank group. The data were analyzed using SPSS 19.0 software package. RESULTS: Histological damage occurred in I/R group at the 7th day, which was more significantly grave than the sham group and blank group. The expression of HIF-1α, Notch-1 protein in IR group at each time point was significantly higher compared to sham group (P<0.05). The expression of HIF-1α, Notch-1 mRNA in IR group at each time point was significantly higher compared to Sham group(P<0.05). CONCLUSIONS: Obvious damage of tissue flaps occurred after ischemia and reperfusion. Notch signaling pathway may be activated for tissue repairing and angiogenesis, and it may be induced by high level expression of HIF-1α under tissue hypoxia after ischemia-reperfusion injury. References | Related Articles | Metrics

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Role of glutathione homeostasis on 2,3,7,8-tetrachlorodibenzo-p-dioxin induced cleft palates in mice ZHAO Tong-chao, BIAN Yuan-yuan, ZHANG Tian-qi, ZHANG Dong-sheng, MA Li. 2018, 16 (3):  215-221.  doi: 10.19438/j.cjoms.2018.03.005 Abstract ( 433 )   PURPOSE: To elucidate the impact of glutathione homeostasis in organogenesis stage embryos on 2,3,7,8-tetrachlorodibenzo-p-dioxin(TCDD) -induced cleft palate in fetal mice. METHODS: Pregnant C57BL/6J mice were randomly allocated to blank control group, TCDD exposed group, L-buthionine-sulfoximine (BSO)exposed group and BSO+TCDD exposed group. Each GD10 animal was weighted and treated with 0.1mL normal saline (for blank control group and TCDD exposed group) or 600 mg/kg BSO (for BSO group and TCDD+BSO group). After 4 hours, TCDD was orally administrated to subjects in both TCDD group and TCDD+BSO group, but corn oil was used as vehicle control for control group and BSO group. Fetal mice palates were imaged using light microscopy on GD13.5, GD14, GD14.25, GD14.5, GD14.75 and GD15; scanning electronmicroscopy was used on GD13.5, GD14.5, and GD15.5, and cleft palate were recorded on GD17.5. Three GD14.5 palate sections from each group were examined by immunohistochemistry.SPSS13.0 software package was used for statistical analysis. RESULTS: TCDD successfully induced cleft palate. BSO can increase 5% of cleft palate. In the TCDD treated group, palatal shelves elevated 1 day later than in the control group. In the TCDD and BSO group, 0.25 day later than the TCDD group, all palates had elevated by GD 15.0. After elevation, the shelves contacted each other and fused. Under a high magnification (×2500), compared to the control group (GD14.5), TCDD group (GD 15), no filaments were observed and cell shapes were flat with unclear boundaries. The group treated with TCDD and BSO had no significant difference from the TCDD group in the end, but had temporal variations. The TCDD exposed group had a higher expression of CYP1A1 on the frontal epithelia than the control group. CONCLUSIONS: Breaking the balance of glutathione may decline the formation of filopodia and MEE motility due to reducing the consumption of reactive oxygen species, filopodia and MEE movement. This may result in accelerating the ultrastructure change of the palatal surface to a normal state, leading to a higher rate of cleft palate in TCDD-treated fetal mice. References | Related Articles | Metrics

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Bone remolding in alveolar cleft site repaired by inorganic ceramic scaffolds loaded with BMP-2 via lyophilization OUYANG Wan-lu, QIAN Yu-fen. 2018, 16 (3):  222-226.  doi: 10.19438/j.cjoms.2018.03.006 Abstract ( 353 )   PURPOSE: To load BMP-2 on a novel inorganic ceramic scaffold material, OsteoBoneTM, through lyophilization, and explore its effect on bone formation after bone graft in vivo. METHODS: BMP-2 was loaded onto OsteoBoneTM scaffolds by coating it via lyophilization with trehalose added as stabalizer. The samples were incubated in PBS in vitro and the release rate was examined with BCA method and alkaline phosphatase (ALP) activity was detected. Eighteen SD rats were used as experimental animals. Critical size defects (CSD) of 4 mm×3 mm×3 mm were established on maxillary alveolar bone in SD rats. Scaffolds alone (group A), BMSC-scaffolds (group B)and BMP-2-scaffolds (group C) were used to be grafted into CSDs. Micro-CT and H-E staining were performed respectively 3,6 weeks post-surgery. SPSS 19.0 software package was used for statistical analysis. RESULTS: BMP-2 performed sustained release and maintained bioactivity for enhanced osteogenesis from lyophilized OsteoBoneTM scaffolds in vitro. Three weeks after surgery, H-E staining showed sparse braided bone, and there was no significant difference between the three groups; there was no significant difference in micro-CT analysis of bone volume/tissue volume (BV/TV) and trabecular thickness. Six weeks after surgery, H-E staining revealed abundant bone regeneration and osseous tissue was mature in group B and group C, and new bone formation trend was more apparent than in group A. Micro-CT analysis showed that BV/TV and trabecular thickness in group B and C was significantly greater than that in group A, and there was no significant difference between group B and group C. CONCLUSIONS: Loading BMP-2 on OsteoBoneTM scaffolds through lyophilization can significantly enhance the osteogenic capacity and achieve a similar effect to mesenchymal stem cells. References | Related Articles | Metrics

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Clinical application of golden ratio in maxillary sinus augmentation and simultaneous implantation GAO Ling, WANG Qi-bo, ZHOU Min-zhan, ZHANG Bo, DOU Zhi-chao, ZHI Ke-qian. 2018, 16 (3):  227-230.  doi: 10.19438/j.cjoms.2018.03.007 Abstract ( 663 )   PURPOSE: To investigate the clinical value of golden ratio in maxillary sinus augmentation and simultaneous implantation. METHODS: Fifteen patients were enrolled with missing maxillary molars and residual bone height(RBH) about 2.0-5.0 mm from Jul. 2016 to Oct. 2017 at the Department of Implantology in the Affiliated Hospital of Qingdao University of West Coast District. The patients underwent maxillary sinus augmentation and simultaneous implantation and followed up for 3-6 months. Golden ratio was used to select the length of implants about 11-12 mm. RESULTS: A total of 21 implants were placed in 15 patients. All patients had good osseointegration of the implants and the surrounding bony tissues on imaging, and none of them had complication, such as maxillary sinusitis, loose implant, peri-implantitis, etc. Six months after operation, restoration was performed, the patients had satisfactory masticatory function and normal soft tissues around the implants. CONCLUSIONS: Application of golden ratio in maxillary sinus floor elevation and simultaneous implantation can solve insufficient RBH in posterior maxillary area， and provide reliable reference for selection of implant length. References | Related Articles | Metrics

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Expression of Cdc42 in tongue squamous cell carcinoma and its clinical significance LIAO Yi-xiang, KONG Qing-nuan, GUO Qing-yuan, HE Zong-xuan, QIU Jing, CHEN Zheng-gang. 2018, 16 (3):  231-236.  doi: 10.19438/j.cjoms.2018.03.008 Abstract ( 671 )   PURPOSE: To investigate expression of cell division cycle 42 (Cdc42) and its clinical significance in tongue squamous cell carcinoma (TSCC). METHODS: Forty-two patients with TSCC were collected and the expression of Cdc42 in tumor, adjacent tissue and normal tissue was detected by immunohistochemistry and Western blot, respectively. The correlation of Cdc42 expression and clinical parameter were analyzed as well. Statistical analysis was performed using t test and rank sum test with SPSS 13.0 software package. RESULTS: The positive rate of Cdc42 in TSCC and adjacent tissue was 80.95% and 52.38%, respectively, which was higher than 11.90% in normal tissue. There was significant difference of Cdc42 expression between tumor, adjacent tissue and normal tissue (P<0.05). Cdc42 protein expression in cases with cervical lymph node metastasis was significantly higher than in cases without cervical lymph node metastasis (P<0.05). The expression of Cdc42 in TSCC had positive relation with clinical stages (P<0.05), but no correlation with pathological grade, age and gender (P>0.05). The expression levels of Cdc42 in nucleus were associated with pathological grade of TSCC. CONCLUSIONS: The results indicated Cdc42 positive expression is higher in TSCC and adjacent tissue. Over-expression of Cdc42 may play an important role in TSCC development and progress. References | Related Articles | Metrics

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Evaluation of the effect of surgically assisted rapid maxillary expansion on the characteristics of nasal airflow NIE Ping, TAO Li, SUN Hui-jun, YU Qian, ZHU Min. 2018, 16 (3):  237-241.  doi: 10.19438/j.cjoms.2018.03.009 Abstract ( 478 )   PURPOSE: To study the effect of surgically assisted rapid maxillary expansion on nasal airflow dynamics by computer numerical simulation. METHODS: The sample comprised 8 adult patients with maxillary transverse deficiency. They had unilateral or bilateral posterior teeth crossbite. Spiral CT scans were taken before treatment(T1) and 3 months after expansion(T2). The three-dimensional model of the upper airway was established by using Mimics10.0 software, and the analysis of computational fluid dynamics was simulated by ANSYS14.0 software in order to obtain the airflow velocity, the nasal cavity pressure, the cross-sectional area of nasal cavity, nasal airway volume and resistance. The nasal airflow parameters were analyzed with SPSS16.0 software package for paired t test, respectively. RESULTS: The whole nasal velocity was tended to be stable after expansion, and it decreased significantly compared with that before expansion(P<0.05). There was more turbulent flows formation in the nasal airway preoperatively than postoperatively. The absolute value of nasal negative pressure decreased after expansion(P<0.05). The cross-sectional area of nasal cavity and nasal volume increased, while the nasal airway resistance decreased significantly after expansion (P<0.05). CONCLUSIONS: Surgically assisted rapid maxillary expansion has certain effect on nasal airway morphology and airflow dynamics, which is beneficial to the improvement of nasal airway ventilation function. References | Related Articles | Metrics

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Modified surgical method for diacapitular condylar fractures in 38 consecutive patients REN Rong, CAI Bo-lei, ZHI Yin, SI Jia-wen, ZHANG Jian-fei, SHI Jun. 2018, 16 (3):  242-247.  doi: 10.19438/j.cjoms.2018.03.010 Abstract ( 1270 )   PURPOSE: To introduce a modified surgical method for diacapitular condylar fractures. METHODS: Thirty-eight patients (50 TMJs) diagnosed as diacapitular condylar fracture through clinical examinations(CT and MRI) were treated with a modified surgical technique from January 2015 to December 2016. The technique was mainly proposed for diacapitular fractures. A minimized preauricular incision and transparotid access was used. Then reduction and fixation of diacapitular condylar fractures were performed. After confirming that the fracture was fixed rigidly, the articular disc was repositioned and anchored by a special anchorage nail. All patients were estimated by CT and MRI pre- or post-surgery, and followed up for 1 year at least. For patients who had other fractures of the mandible, open and internal fixation were conducted simultaneously. Radiologic, anatomic and objective functional parameters (axiography and MRI) were used to assess the vertical height, disk mobility, protrusive and translatory movement as well as potential physical complaints. All results were statistically analyzed with SPSS 17.0 software package. RESULTS: Spiral CT revealed that 96.0% (48/50 TMJs) of DCFs were correctly reduced and fixed. All patients showed significant difference in the vertical height between preoperation and postoperation (P<0.05) and there was no significant difference between the uninjured side and the postoperative affected side (P>0.05) in19 unilateral DCFs. Postoperative MRI showed that the displaced discs were reduced to its normal position in 46 of 50 TMJs(92.0%). Long-term follow-up of 38 patients included mouth opening(35.67 mm), maximum lateral occlusion (4.45 mm), maximum protrusive occlusion (5.63 mm), mouth open with deviation in 2 cases (5.3%), TMJ click in 2 cases(4.0%), facial nerve injury in 4 cases (3 cases were recovered spontaneously 3 months after surgery, another relieved by taking mecobalamin orally) and all occlusion was stable. CONCLUSIONS: This modified technique was proposed for DCF, clinical results were very good and should be popularized in clinic, but further evaluation was necessary. References | Related Articles | Metrics

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Radiotherapy for head and neck cancer of unknown primary sites: Is there a clinical benefit to elective mucosal irradiation? FENG Kun， DOU Sheng-jin， ZHU Guo-pei， ZHANG Zhi-yuan. 2018, 16 (3):  248-252.  doi: 10.19438/j.cjoms.2018.03.011 Abstract ( 343 )   PURPOSE: The optimal management is still controversial in head and neck cancer of unknown primary sites. Particular areas of controversy persist regarding whether elective mucosal irradiation should be performed. METHODS: Clinical data of patients with head and neck cancer of unknown primary sites treated with radiotherapy from 2009.01 to 2016.04 were retrospectively collected. Survival curves were estimated with Kaplan-Meier method and log-rank test with SPSS 20.0 software package. RESULTS: After a median follow-up of 63 months (range 5-126 months), the 5-year mucosal control rate was 100% and 72.0% (P=0.003) in patients treated with elective mucosal irradiation and neck treatment; the 5-year neck control rate was 92.9% and 57.7% (P=0.002), respectively. Primary tumor emerged in 7(26.9%) patients from the neck treatment group. CONCLUSIONS: Elective mucosal irradiation helps to provide a better balance between efficiency and toxicity in patients with head and neck cancer of unknown primary sites. Prospective study with more patients and long follow-up are needed. References | Related Articles | Metrics

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Primary intraosseous squamous cell carcinoma of the mandible: clinical, pathological and prognosis analysis of 34 consecutive cases KUDUSI·Keyimu, CHEN Yi-ming, XU Qian, JI Tong. 2018, 16 (3):  253-258.  doi: 10.19438/j.cjoms.2018.03.012 Abstract ( 1077 )   PURPOSE: To analyze the clinical and pathological features as well as the prognostic factors for primary intraosseous squamous cell carcinoma of the mandible. METHODS: A retrospective study for primary intraosseous squamous cell carcinoma patients treated in our hospital from 2010 to 2015 was executed. The clinical, radiological, pathological, treatment information and follow up records were collected. Statistical analysis was performed with SPSS 17.0 software package. RESULTS: There were a total of 36 patients treated in the given time period, among them 34 were followed-up: 22 were male and 12 were female; 23 were within the age group of 31-60 years old, 11 were above 60 years old. Thirteen had smoking history, 4 had previous alcohol hobby. The median tumor size was 4 cm while 21 was < 4 cm and 13 was >4 cm. Nine had positive cervical lymph nodes in final pathological results, no positive surgical margin was found. Twenty-eight received postoperative radiotherapy, 9 died of locoregional recurrence or metastasis during follow-up. CONCLUSIONS: Surgery is the main approach for treating primary intraosseous squamous cell carcinoma of the mandible. Tumors outside the body of mandible, positive cervical lymph node were related to high rate for locoregional recurrence. Patients with previous alcohol hobby seemed to have high possibility of tumor metastasis postoperatively. Tumor size > 4 cm significantly reduces overall survival rate. References | Related Articles | Metrics

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Clinical classification of extraction difficulty for embedded multiple teeth in 178 children SHEN Yan, SHI Yu，ZHOU Jian-guo, SHEN Hai-ping. 2018, 16 (3):  259-262.  doi: 10.19438/j.cjoms.2018.03.013 Abstract ( 750 )   PURPOSE: To investigate the clinical classification of extration difficulty for embedded multiple teeth in children(EMTC). METHODS: Two hundred and fifty teeth of 178 children with embedded multiple teeth were examined by cone-beam CT(CBCT）. According to the relationship between adjacent embedded multiple teeth and permanent teeth, they were divided into 3 types. Type I:embedded multiple teeth located on the crown of permanent teeth; type Ⅱ: embedded multiple teeth located to the body of permanent teeth; type Ⅲ: embedded multiple teeth located to the root apex of the permanent teeth. The embedded multiple teeth were further divided into 2 classes. Class A: the angle of malformation was<90° with the axis of the crown and root, and the tooth was of straight deformity. Class B: the malformation angle was >90° with the crown-root axis, and the tooth was hook-shaped. The embedded multiple teeth were extracted accordingly based on the different type and class. RESULTS: ：One hundred and seventy-six teeth belonging to type Ⅰ, type Ⅱand class A were removed immediately when the adjacent permanent teeth were not fully developed. Twelve teeth belonging to type Ⅱ, class A, and 62 teeth belonging to type Ⅲ and class B were removed secondly when the adjacent permanent teeth were fully developed. All 250 teeth were removed without damage to the adjacent permanent teeth. CONCLUSIONS: This classification based on teeth morphology is of certain clinical usefulness in predicating extraction difficulty and guidance of operation. References | Related Articles | Metrics

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Investigation and preventive control of sharp injuries among nurses during oral and maxillofacial surgery ZHU Yong-gan, CHEN Na. 2018, 16 (3):  263-265.  doi: 10.19438/j.cjoms.2018.03.014 Abstract ( 367 )   PURPOSE: To investigate the status and causes of sharp injuries in nurses during oral and maxillofacial surgery, in order to make effective protective measures to reduce the occurrence of sharp injuries. METHODS: A retrospective study was conducted on sharp injuries for 102 nurses in the operating room during January 2016 to March 2017 on the basis of questionnaire surgery. The types of sharp injuries, the causes and the operation steps were analyzed. According to the results of investigation and analysis, appropriate protective measures were taken. RESULTS: The incidence of sharp injuries was 87.2% in nurses during oral and maxillofacial surgery, 57.1% in nurses with ≥5 years of working experience, 95.6% in nurses with fewer than 5 years of working experience, 91.6% in new staff and 95.6% in internship students. Injury objects induced by needles, blade, glass; injury happened during transmission of equipment, postoperative arrangement of equipment and cleaning equipment. CONCLUSIONS: Due to the fine surgical instruments, many kinds of needles, long operation time and more chances to contact sharp instruments, sharp injuries are prone to happen during oral and maxillofacial surgery. By targeted prevention measures, sharp injuries can be effectively prevented. References | Related Articles | Metrics

Clinical Reports

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Assessment of clinical outcome of submental island flap used in reconstruction of intraoral defect after resection of early oral cancers WANG Chao, TANG Li-ping, ZHANG Jun. 2018, 16 (3):  266-269.  doi: 10.19438/j.cjoms.2018.03.015 Abstract ( 386 )   PURPOSE: To assess the clinical outcome of submental island flap used in reconstruction of intraoral defect after radical ablation of early oral cancers. METHODS: From November 2014 to August 2017，24 submental island flaps were used to reconstruct soft tissue defects after radical ablation of early oral squamous cell carcinoma (16 in tongue, 5 in gingival, 3 in buccal mucosa). Supraomohyoid neck dissection was performed in all patients. The clinical outcome such as flap survival, tumor recurrence, survival time, and quality of life were reviewed. RESULTS: Twenty-three submental flap transfers were successful, accounting for 96%. One local recurrence of gingival SCC was found, accounting for 4%. Two patients of tongue SCC had postoperative cervical lymph node metastasis, accounting for 8%. No death was noted during 3-30 months of follow-up. The functional and esthetic results were satisfied for all patients. CONCLUSIONS: Simpler fabrication, less time, higher success rate, and easy postoperative care make submental island flap an reliable choice for reconstruction of intraoral defects after resection of early oral cancers. References | Related Articles | Metrics

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Efficacy and safety of reconstruction of mandibular defect in 40 patients with osteoradionecrosis of the jaw with free fibular osteomyofascial compound flap LIU Jun-ping, LI Qun-xing, ZHANG Han-qing, OU Zhan-peng, FAN Song, LI Jin-song. 2018, 16 (3):  270-274.  doi: 10.19438/j.cjoms.2018.03.016 Abstract ( 386 )   PURPOSE: To explore the clinical efficacy of free fibular osteomyofascial compound flap in mandibular defect reconstruction in patients with osteoradionecrosis of the jaws (ORNJ). METHODS: From March 2014 to July 2017, 40 patients with mandibular ORNJ undergoing oral and maxillofacial surgery at Sun Yat-sen Memorial Hospital of Sun Yat-sen University were enrolled. All patients had primary nasopharyngeal carcinoma, excluding recurrent nasopharyngeal carcinoma. Free peroneal dermis fascia composite flap was used to reconstruct bone defects after surgical resection of the radiated mandibular necrosis. The skin and soft tissue defects were repaired with skin island. Fascia was used for mucosal defect repair to fill the soft tissue defects. The fibular osteotomy and tissue flap survival, donor, complications, postoperative mouth opening and occlusion of remaining teeth were evaluated for reconstruction outcomes. RESULTS: After 3 to 6 months of follow-up, free fibular peroneal fascial composite flap was successfully used to reconstruct mandibular defects. Mandibular osteotomy was 5.5-16.0 cm in length, and the harvested fibula was 7.5-17.0 cm in length. No patient had serious donor or recipient site complications. All patients had satisfactory facial shape, remaining normal occlusion, and mouth opening was 1.0-3.5 cm. CONCLUSIONS: Free fibular peroneal fascia composite flap can reconstruct maxillofacial soft and hard tissue defects after radio in patients with ORNJ and reduce complications, which is worthy of clinical application. References | Related Articles | Metrics

Expert Consensus

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Expert consensus on the treatment of oral and maxillofacial hemangiomas and vascular malformations by lauromacrogol sclerotherapy 2018, 16 (3):  275-278.  doi: 10.19438/j.cjoms.2018.03.017 Abstract ( 748 )   [Summary] Hemangiomas and vascular malformations are a complex group of lesions developed from the vascular system. Infantile hemangiomas are vascular neoplasms due to the proliferation of endothelial cell and are the most common vascular tumours of infancy. Vascular malformations are the results of abnormal development of the vascular system during embryogenesis and more than 60% of them are localized in the head and neck regions. Vascular anomalies may cause severe facial deformity and dysfunction. Sclerotherapy is a commonly used method for the treatment of vascular anomalies. The documented sclerosing agents included pingyangmycin, bleomycin, absolute ethanol, OK-432 (picibanil), doxycycline, sodium tetradecyl sulfate, and ethanolamine oleate. In recent years, a domestic produced sclerosant named polidocanol have been widely used in the treatment of vascular anomalies. The development of foam sclerotherapy technique has promoted its clinical application of lauromacrogol and the efficacy and safety of foam sclerotherapy has been proved by a large number of studies in the treatment of vascular anomalies. In order to standardize the application of these new detergent sclerosants, we established this expert consensus. This protocol will be renewed and updated based on the newest published literatures and clinical experiences, and provide further guidance for clinicians involving in this specialty. References | Related Articles | Metrics

Review Articles

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Research progress of 3D bio-printing technology in treatment of oral and maxillofacial bone defects CHEN Xu-zhuo, ZHOU Zhi-hang, ZHENG Ji-si, ZHANG Shan-yong, Yang Chi. 2018, 16 (3):  279-283.  doi: 10.19438/j.cjoms.2018.03.018 Abstract ( 439 )   [Summary] Based on the rationale of 3D printing, 3D bio-printing serves as a sort of tissue engineering technology, utilizing computer aided design technology to build virtual three-dimensional structure of tissues and organs, and then creates the desired entity step by step with the use of corresponding biological materials. 3D bio-printing has made several remarkable achievements in the field of regenerative medicine, with a promising prospect for clinical application. With regard to the repair of oral and maxillofacial defects, 3D bio-printing technology reconstructs the anatomical structure of defects accurately by making use of various biological composite materials to build personalized implants layer by layer. This technology increases the stability of implants and the binding rate of implants and normal tissues. As a result, both the morphology and functions of tissues are restored. Based upon the research data both at home and abroad, the history and category of 3D bio-printing technology as well as the progress and dynamic of biological materials, cells and bioactive factors applied in oral and maxillofacial bone defect repair were introduced in this review. References | Related Articles | Metrics

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Types and treatment of deep overbite: recent research advances YANG Shuang-yu, QIAN Yu-fen. 2018, 16 (3):  284-288.  doi: 10.19438/j.cjoms.2018.03.019 Abstract ( 548 )   [Summary] Deep overbite is prevalent nowadays, however the treatment is quite difficult. Deep overbite was represented by dental deep overbite and skeletal deep overbite according to the mechanisms. In this article, both types of deep overbite were illustrated with clinical features, cephalometric measurements and treatment methods, with the hope of being helpful for clinical work. References | Related Articles | Metrics