China Journal of Oral and Maxillofacial Surgery

Effect of quercetin on angiogenesis and its molecular mechanism in human umbilical vein endothelial cells

GUI Zhi-peng, ZHOU Yu-ning, HU Yue, XIA Lun-guo, XU Yuan-jin

2018, 16 (5): 385-390. doi: 10.19438/j.cjoms.2018.05.001

Abstract ( 516 )

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PURPOSE: To investigate the effect of quercetin on angiogenesis and the biological characteristics of human umbilical vein endothelial cells (HUVECs). METHODS: HUVECs were treated with quercetin (1,5 and 10 μmol/L). CCK8 assay was used to assess the effect of quercetin on HUVECs proliferation. Wound healing assay and Matrigel-based tube formation assay were applied to observe migration and tube formation of HUVECs. Real-time PCR was used to evaluate gene expressions of VEGF and bFGF in HUVECs. Western blot was preformed to detect the change of AKT signaling pathway. Differences between groups were analyzed with SPSS 17.0 software package for ANOVA and Tukey post hoc analysis. RESULTS: Compared with the control group, quercetin significantly suppressed HUVECs proliferation, migration and tube formation in a dose-dependent manner. Gene expression of VEGF and bFGF in quercetin treated groups was significantly less than in the control group. Western blot indicated that quercetin inhibited AKT signaling pathway in HUVECs in vitro. CONCLUSION: Quercetin suppresses proliferation and angiogenesis of HUVECs in vitro, the potential mechanism of the inhibition partly involves in blockage of AKT signaling pathway.

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The expression of beta adrenergic receptor in CAL-27 cell line of tongue carcinoma and the effects of beta blockers on proliferation, migration and invasion

LIU Shi-qi, YANG Liang-hui, CHEN Guo-sheng, WANG hui, FANG fang, LIAO Xian-xiang, MAI Hua-ming

2018, 16 (5): 391-396. doi: 10.19438/j.cjoms.2018.05.002

Abstract ( 296 )

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PURPOSE: To investigate the expression of β adrenergic receptors in CAL-27 cell line of tongue carcinoma and the effects of β-blockers on the proliferation , migration and invasion of CAL-27 cells. METHODS: Normal oral mucosal epithelial cells (NOMEC) were cultured and identified. Immunohistochemistry and real-time quantitative PCR(qRT-PCR) were applied to detect the expression of β-adrenergic receptor in CAL-27 and oral mucosal epithelial cells. The proliferation, migration and invasion of CAL-27 cells were investigated by CCK-8 method, scratch adhesion test and Transwell assay under different concentrations of propranolol and metoprolol. Experimental data were analyzed with analysis of variance and t test by SPSS 16.0 software package. RESULTS: The expression of β1-AR and β2-AR in CAL-27 cells were higher than that in NOMEC, while the expression of β2-AR at mRNA level were lower than that in NOMEC, the expression of β1-AR was higher than that in NOMEC. CCK-8 assay showed with the increase of drug concentration, the inhibitory effect on CAL-27 cell proliferation was enhanced. When the drug concentration was >50 μmol/L, the inhibiting effect of propranolol on cell proliferation was significant (P<0.05). Scratch-wound assay showed that when drug concentration was >2.5 μmol/L, migration of CAL-27 cells was inhibited (P<0.05), and propranolol had a greater inhibitive effect. Transwell assay showed that when drug concentration >1.0 μmol/L,invasion of CAL-27 cells was suppressed (P<0.05), the suppression effect of propranolol was greater. CONCLUSIONS: The expression of β1-AR in CAL-27 cells is significantly higher than that in NOMEC and the expression of β2-AR is lower than that in NOMEC. Low concentration of propranolol and metoprolol has no significant effect on proliferation of CAL-27 cells, but can inhibit the migration and invasion of CAL-27 cells.

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Experimental study of acellular and demineralized human tooth in repair of calvarial bone defect in rats

LIU Zong-lin, GUO Ke, WANG Wen-chao, ZHANG Yao-sheng, XU Wei-feng, ZHANG Shan-yong, LIU Xiu-ming, JIN Jia-min

2018, 16 (5): 397-401. doi: 10.19438/j.cjoms.2018.05.003

Abstract ( 289 )

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PURPOSE: To investigate the feasibility of acellular decalcified human teeth as bone scaffold materials and their ability to induce bone defect and osteogenesis in rats. METHODS: Twenty-four isolated human teeth were treated with decalcification and decellularization respectively. In experiment 1, 6 male SD rats aged 10-12 weeks were used to embed decalcified teeth and acellular and demineralized teeth under the skin of the abdomen of the rats. After 4 weeks, the rats were sacrificed and H-E staining was performed to observe the inflammatory reaction around the two materials. In experiment 2, 12 male SD rats of 10-12 weeks old were selected to prepare bilateral calvarial bone defects,the left side of the bone defect was implanted with decalcified and acellular teeth, while the right side of the bone defect without any material was used as a blank control. Six rats were randomly selected for 4 weeks and 8 weeks respectively to be sacrificed. Complete specimens were obtained and Micro- CT scan was performed to compare bone mass from the general morphology. Rats at 4 weeks were taken for H-E staining and immunohistochemistry to observe the peripheral inflammatory response and the extent of newly formed bone. SPSS 23.0 software package was used for ANOVA of repeated measurement. RESULTS: After 4 weeks, H-E staining showed that the inflammatory reaction between acellular and demineralized teeth and surrounding tissues was significantly less than that of decalcified teeth. Micro-CT scanning and quantitative analysis of 4 and 8 weeks of rat calvarial bone showed that the bone mass in the bone defect implanted with acellular and demineralized teeth was significantly higher than that in the blank control (P<0.05). The results of H-E staining of rats at 4 weeks showed that the inflammatory response around the acellular and demineralized teeth was similar to the blank control. Immunohistochemical results showed that the number of new osteoblasts around the acellular and demineralized teeth was significantly higher than that of the blank control. CONCLUSIONS: Decalcified and decellularized teeth are a kind of biological scaffold material with good biocompatibility,osteogenic induction ability and plasticity.

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Effects of risedronates on Bcl-2 and BAX expression in osteoporotic rat mandibular alveolar bone

WEI Li, ZHOU Qi, JIANG Li-ting, LI Ning, GAO Yi-ming

2018, 16 (5): 402-408. doi: 10.19438/j.cjoms.2018.05.004

Abstract ( 261 )

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PURPOSE: This study was to investigate the impact of risedronates on mandibular alveolar bone microstructure, anti-apoptotic factor Bcl-2 and apoptotic factor BAX expression and osteocyte apoptosis in an ovariectomized rat model. METHODS: Thirty 6-month-old female SD rats were divided into 3 groups (ten in each group): Sham group, OVX group (bilateral ovariectomy) and RIS group (bilateral ovariectomy, followed by administration of risedronate). Three months later, the mandibles of all animals were harvested and assessed by micro-CT and histological analysis. Osteocyte apoptosis was observed by TUNEL staining and the expression of Bcl-2 and BAX was evaluated by immunohistochemical staining. The data were analyzed using SPSS 13.0 software package. RESULTS: Ovariectomy caused significant alveolar bone loss and greater osteocyte apoptosis in OVX group than in sham group. The systemic risedronate-treated group exhibited a significant increase in BV/TV and decrease in trabecular separation and osteocyte apoptosis, together with an increase in Bcl-2 expression and the ratio of Bcl-2/BAX, when compared with those of the OVX group (P<0.05). CONCLUSIONS: Systemic treatment of risedronates can increase the expression of Bcl-2 and the ratio of Bcl-2/BAX in mandibular alveolar bone. It partially reverses alveolar bone loss and suppresses osteocyte apoptosis in ovariectomized rats.

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Expression of bone marrow stromal antigen-2 in primary Sjogren's syndrome and its clinical significance

CHEN Chan, ZHENG Ling-yan, SHI Huan, YU Chuang-qi, CAO Ning-ning

2018, 16 (5): 409-415. doi: 10.19438/j.cjoms.2018.05.005

Abstract ( 306 )

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PURPOSE: To analyze bone marrow stromal antigen-2 (BST-2) levels in labial glands, total peripheral blood mononuclear cells (PBMCs) and PBMC subpopulations from primary Sjögren's syndrome (pSS) patients, and explore the role of BST-2 in the pathogenesis of pSS. METHODS: PBMC subsets were positively separated using magnetic microbeads. BST-2 mRNA levels in labial glands, total PBMCs and PBMC subsets of 30 pSS and 30 healthy control (HC) subjects were investigated using real-time PCR (RT-PCR). Distribution of BST-2-positive cells in the labial glands was assessed by immunohistochemistry. Lentivirus transfection in Raji cells were conducted to determine the biologic function of BST-2. SPSS 16.0 software package was used for statistical analysis. Differences between the groups were analyzed using Mann Whitney test, and correlations were assessed using Spearman correlation analysis. RESULTS: BST-2 was increased in pSS labial glands and was positively correlated with VAS value for parotid gland swelling and rheumatoid factor and β2-microglobulin serum levels. BST-2 levels were significantly different between pSS patients with positive and negative expression of anti-SSA antibody. Positive focal infiltrating lymphocytes and adjacent ductal epithelial cells were observed in labial glands from pSS patients, while there were a few scattered positive ductal epithelial cells in controls. BST-2 was up-regulated in peripheral CD19⁺ B cells and labial CD19⁺ B cells from pSS patients. BST-2-overexpressed Raji cells possessed higher proliferative activity and lower apoptotic rate. CONCLUSIONS: BST-2 was aberrantly expressed in B cells of pSS patients, and expression in labial glands was positively correlated with important clinical characteristics. BST-2 might accelerate the progress of pSS by promoting infiltration of B cells.

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Comparison of the outcomes of an extensive segmental pectoralis major myocutaneous flap via the anterior axillary line and the conventional technique for reconstruction of defects after ablative surgery of oral and oropharyngeal cancers

ZHOU Bin, ZHUANG Xiu-mei, CHEN Wei-liang, ZHANG Da-ming, WANG Xun-ming, ZHOU Jia-min

2018, 16 (5): 416-419. doi: 10.19438/j.cjoms.2018.05.006

Abstract ( 326 )

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PURPOSE: To compare the outcomes of an extensive segmental pectoralis major myocutaneous flap (esPMMF) and a conventional pectoralis major myocutaneous flap (cPMMF) in reconstruction of defects after ablative surgery of oral and oropharyngeal cancers. METHODS: The study enrolled 91 patients with primary oral and oropharyngeal cancer who underwent radical resection, followed by reconstruction of the defect using either an esPMMF via the anterior axillary line or a cPMMF. RESULTS: The pedicle lengths of the esPMMF and cPMMF were 22-28 cm and 18-22 cm, respectively. The esPMMF and cPMMF had skin paddle dimensions of 5 cm×8 cm to 7 cm×14 cm and 6 cm×7 cm to 8 cm×17 cm, respectively. The range of shoulder abduction was significantly greater in the esPMMF group and the donor site esthetic results were better. CONCLUSIONS: esPMMF has a longer pedicle flap, enables a greater range of shoulder abduction, and has a better esthetic results than the conventional technique.

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Effect of modified costochondral graft in temporomandibular joint reconstruction with lateral pterygoid muscle preservation technique

WANG Xiang-yu, BAI Guo, DONG Min-jun, HUO Liang, ZHENG Ji-si, CHEN Min-jie, YANG Chi

2018, 16 (5): 420-424. doi: 10.19438/j.cjoms.2018.05.007

Abstract ( 413 )

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PURPOSE: To explore a modified temporomandibular joint reconstruction which can preserve the maximum function of lateral pterygoid muscle. METHODS: In 3 cases with severe temporomandibular joint osteoarthrosis who received temporomandibular joint reconstruction with costochondral graft, we kept the integrity of condyle and lateral pterygoid muscle attachment and move them downwards to preserve the muscle function. Consecutive follow-ups, both radiographic and clinical, were carried out to evaluate its effectivity and reliability. RESULTS: Postoperative CT scan showed a satisfactory bone healing and almost normal lateral pterygoid muscle patterns. The one-year follow-up of 3 case series showed a desirable recovery of mouth opening, mandible movement range and diet quality. CONCLUSIONS: Lateral pterygoid muscle preservation technique showed an inspiring result of postoperative mouth opening recovery and improving range of lateral mandibular movement.

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Clinical analysis of nasal floor reconstruction by oral mucosal flap in 16 patients with non-syndromic unilateral complete cleft lip

LI Yi-ying, YANG Xue-cai, HOU Zhi-jun, HU Ning-ning, WANG Jun-wei, CHU Xiao-yi, XIN Jun-tong

2018, 16 (5): 425-430. doi: 10.19438/j.cjoms.2018.05.008

Abstract ( 301 )

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PURPOSE: To explore the effect of applying oral mucosal flap to repair nasal floor of patients with non-syndromic unilateral complete cleft lip in one-stage operation. METHODS: Sixteen patients with unilateral complete cleft lip treated at School of Stomatology, Medical College of Qingdao University from September 2014 to September 2016 were retrospectively analyzed. Their nasal floor was repaired with oral mucosal flap. Photographs were taken before repair, 1 week and 1 year after surgery. The symmetry ratio of nasal floor and alar shape were calculated to analyze the clinical effect. SPSS 19.0 software package was used for statistical analysis. RESULTS: There was no oral-nasal fistulas(ONFs) and nasal floor notches in 16 cases. The nasal wing collapse was improved obviously. One year after operation, the symmetrical ratio of nasal floor width was 0.79±0.15, and the ratio of nostril width symmetry was 0.856±0.17, nostril height symmetry was 1.44±0.17, symmetrical ratio of nasal column was 1.62±0.48. There was significant difference before and after operation. CONCLUSIONS: Nasal floor repair in children with non-syndromic unilateral complete cleft lip with oral mucosal flap in one-stage operation can not only be beneficial to reduce the incidence of oral and nasal fistulas, but also help to close the fissure of nasal floor, restore the shape of nasal floor and properly correct nasal deformity.

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Efficacy and safety of transdermal buprenorphine versus transdermal fentanyl in patients with persistent postoperative pain after oral malignant tumor surgery

LI Meng-ya, SUN Yu, JIANG Hong

2018, 16 (5): 431-435. doi: 10.19438/j.cjoms.2018.05.009

Abstract ( 733 )

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PURPOSE: To compare the efficacy and safety of buprenorphine transdermal patch and fentanyl transdermal patch for postoperative persistent pain after oral malignant tumor surgery. METHODS: According to a computer-generated randomized list, the patients were randomly divided into buprenorphine transdermal patch group (experimental group) and fentanyl transdermal patch group (control group), 52 cases in each group. The differences in VAS pain scores, number of remediation drug, incidence of adverse reactions, and differences in overall satisfaction between the two groups before and after use were compared on days 1, 3, 5, 7, 14, 21, and 28. SPSS 23.0 software package was used for statistical analysis. RESULTS: A total of 104 cases were included, and 96 completed the study: 49 patients in the buprenorphine transdermal patch group and 47 in the fentanyl patch group. There was no significant difference in VAS pain score between the two groups before and after the use of patch (P>0.05); there was no significant difference between the two groups in the total number of tramadol hydrochloride (P>0.05). The incidence of constipation was not statistically significant (P>0.05). The incidence of nausea, vomiting and drowsiness was significantly lower in the experimental group than in the control group (P<0.05). The patients' satisfaction of the experimental group was significantly higher than that of the control group (P<0.05). CONCLUSIONS: Transdermal buprenorphine patch for oral cancer patients with persistent pain after analgesic effect is equivalent to fentanyl patch, but with less lethargy, nausea, vomiting and fewer other adverse reactions. It is easy to use, and the degree of patients' satisfaction is high.

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Effect of TPF induced chemotherapy combined with postoperative radiotherapy on oral squamous cell carcinoma and its impact on expression of ING4 and Annexin A1

LI Huai-qi, WU He-ming, DING Xu, YE Jin-hai, WU Yu-nong

2018, 16 (5): 436-440. doi: 10.19438/j.cjoms.2018.05.010

Abstract ( 431 )

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PURPOSE: To observe the clinical effect of TPF induced chemotherapy combined with postoperative radiotherapy on oral squamous cell carcinoma (OSCC) and its impact on expression of ING4 and Annexin A1. METHODS: A total of 146 patients with oral squamous cell carcinoma (OSCC) treated from June 2013 to June 2015 in our hospital were selected. According to random digital table, the patients were divided into observation group and control group with 73 cases in each group. Patients in observation group were treated with TPF induced chemotherapy and postoperative radiotherapy; while patients in the control group were treated with surgical resection plus postoperative radiotherapy. The clinical efficacy of the two groups was observed and compared. The expression of ING4 and Annexin A1 in the two groups before and after treatment was detected. The incidence of adverse reactions, 1- and 2-year survival rates were recorded and compared between the two groups. SPSS19.0 software package was used for statistical analysis. RESULTS: The total remission rates of the observation group and the control group were 88.41% and 58.57%, respectively. The total remission rate of the observation group was significantly higher than that of the control group (χ²=23.690, P=0.000). Before treatment, the positive expression rate of ING4 and the relative expression level of Annexin A1 were similar between the two groups (P>0.05). After treatment, the positive expression rate of ING4 in the observation group was significantly higher than that of the control group (P<0.05), and the relative expression level of Annexin A1 in the observation group was significantly lower than that of the control group (P<0.05). The 1- and 2-year survival rates in the observation group were significantly higher than those in the control group (P<0.05). The incidence of nausea, vomiting, oral mucosa damage, leucopenia and radionuclide rash in the observation group were significantly higher than those in the control group (P<0.05). CONCLUSIONS: TPF induced chemotherapy combined with postoperative radiotherapy can effectively improve the clinical efficacy and short-term survival rate of patients with oral squamous cell carcinoma. The possible mechanisms involved increasing the expression of ING4, reducing the expression of Annexin A1 and promoting apoptosis.

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Analysis of risk factors of alveolar bone defect and inferior alveolar nerve injury after extraction of impacted mandibular third molar

SUN Lei, ZHAO Qi-rong, ZHENG Hao

2018, 16 (5): 441-444. doi: 10.19438/j.cjoms.2018.05.011

Abstract ( 563 )

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PURPOSE: To investigate the influencing factors of alveolar bone defect and inferior alveolar nerve (IAN) injury after mandibular mesially impacted third molar extraction, and to provide reference for future development of more targeted preventive measures. METHODS: The clinical data, imaging data and follow-up data of 500 cases of mandibular impacted third molar extraction were retrospectively analyzed, and the data of the patients with no alveolar bone defect and IAN injury were compared and analyzed. The independent risk factors of alveolar bone defect and IAN injury were analyzed by logistic regression analysis with SPSS 18.0 software package. RESULTS: In 500 patients, 52 (10.40%) had IAN damage. Single factor analysis and Logistic regression analysis showed that the age of patients, surgical incision, dental instruments, dental surgery, postoperative complications (hematoma, infection, dry socket) were factors of alveolar bone defect and IAN injury (P<0.05). CONCLUSIONS: The age of patients, anatomical structure of the impacted third molar, the relationship between the anatomical structure, the position of the root and the mandibular canal should be fully investigated before operation, in order to prevent and minimize postoperative complications.

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Mental health, psychological demand and nursing countermeasures in female patients with maxillofacial trauma

LI Li-hua

2018, 16 (5): 445-448. doi: 10.19438/j.cjoms.2018.05.012

Abstract ( 367 )

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PURPOSE: To investigate and analyze the situation of mental health and psychological needs in female patients with maxillofacial trauma, in order to give nursing intervention. METHODS: Three hundred and twenty female patients with maxillofacial trauma were included for a questionnaire survey. The questionnaire consisted of "symptom rating scale ( SCL -90 )"and "psychological demand questionnaire of female maxillofacial trauma patients". The data were analyzed with SPSS 16.0 software package. RESULTS: Psychosomatic symptoms were formed in female patients with maxillofacial trauma, mainly physical and psychological depression. The highest score was aesthetic demand, followed by physiological demand. CONCLUSIONS: Female patients with maxillofacial trauma had varying degrees of psychological problem, nurses should understand and give them corresponding nursing measures for rehabilitation.

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Application of bilateral sliding red lip flaps in correction of the secondary lip deformities of bilateral cleft lip with postoperative vermilion tubercle defect in 5 consecutive cases

LIANG Yun, YANG Yu-sheng, WU Yi-lai

2018, 16 (5): 449-451. doi: 10.19438/j.cjoms.2018.05.013

Abstract ( 371 )

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PURPOSE: To investigate the effectiveness of bilateral sliding red lip flaps for secondary lip deformities correction of bilateral cleft lip with postoperative vermilion tubercle defect. METHODS: Between March 2015 and May 2017, five patients with postoperative bilateral cleft lip vermilion tubercle defect were treated. There were 2 males and 3 females with a median age of 13 years old and an average age of 14 years old (ranged from 7 to 26 years old). Secondary lip deformities correction with bilateral sliding red lip flaps was done under general anesthesia. On the basis of red lip open incision, bilateral sliding red lip flaps were used to reconstruct the vermilion tubercle. At the same time, whistling lip deformity was eliminated. RESULTS: All incisions healed primarily. Good aesthetic results were obtained in all 5 cases with satisfactory vermilion tubercle appearance during 2-26 months of follow-up. CONCLUSIONS: Bilateral sliding red lip flaps can reconstruct vermilion tubercle defect, and it is worth of wide application.

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Retrospective study of 49 comminuted mandibular fractures

LIU Shu-li, XU Bing, SHI Jun

2018, 16 (5): 452-455. doi: 10.19438/j.cjoms.2018.05.014

Abstract ( 445 )

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PURPOSE: To summarize the treatment of comminuted mandibular fractures. METHODS: The records of 49 patients with comminuted mandibular fractures were analyzed for treatment and outcomes. RESULTS: Among 49 patients, 33 were male, 16 were female; 31% were traffic accident injury, 10 had postoperative infection, 1 had malocclusion, 1 had temporo-mandibular joint ankylosis, 1 had nonunion, the complication rate was 26.5%. CONCLUSIONS: There are several approaches to manage comminuted mandibular fracture, however, the infection rate was still high and the therapeutic effect is not good.

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History of the international temporomandibular joint surgery

MAO Yi, CHEN Xu-zhuo, ZHANG Shan-yong

2018, 16 (5): 456-459. doi: 10.19438/j.cjoms.2018.05.015

Abstract ( 484 )

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With the evolution of the human being, the shape of jaws gradually changes and temporomandibular joint disease becomes a problem. Temporomandibular joint disorder is one of the most vital concerns in oral and maxillofacial surgery. Ever since the earliest documentary records, there has been a tremendous development in temporomandibular joint surgery, and recent advancements are never possible without numerous clinical trials and other efforts. In aim of providing a proper and comprehensive reference,this paper reviewed the history of international temporomandibular joint surgery,with a summary of key milestone events.

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