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20 January 2020, Volume 18 Issue 1 Previous Issue    Next Issue

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Expert Consensus

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Chinese expert consensus on diagnosis and clinical management of malignant hyperthermia in oral medicine TANG Zhan-gui, BU Rong-fa, GUO Wei, SUN Mo-yi, ZHENG Jia-wei, PENG Xin, ZHANG Hui, DUAN Xiao-hong, JIANG Hong, WANG Miao, ZHANG Tie-jun, YANG Xu-dong, YANG Kai, YU Jian-jun, LUO Zhi-yong, XIE Yong-qiu, HU Yan-jia, WANG Bai-sheng 2020, 18 (1):  1-9.  doi: 10.19438/j.cjoms.2020.01.001 Abstract ( 497 )   PDF (6468KB) ( 335 )   Malignant hyperthermia (MH) is an autosomal dominant disease induced by anesthetic drugs or other factors and present a series of pathologic physiology and clinical changes in patients with susceptibility. MH is prone to occur in adolescents, and patients may be accompanied by congenital diseases like cleft lip and palate. Due to the wide application of all kinds of anesthetic drugs in clinical procedures, this disease has attracted more and more attention from clinicians. The treatment of MH has its particularity, misdiagnosis and mistreatment may lead to serious consequences even death. The purpose of formulating the consensus of experts on MH in oral medicine is to hope that the majority of oral clinicians are alert to the occurrence of MH in the process of diagnosis and treatment, reduce misdiagnosis and mistreatment of MH, and improve the treatment success rate of patients. References | Related Articles | Metrics

Original Articles

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Cisplatin induces epithelial-mesenchymal transition in tongue squamous carcinoma cells and obtains tumor stem cell-like characteristics LIU Guo-xin, WANG Wei-wei, MAI Lian-xi, JIAO Jiu-yang, XIE Shu-le, LIN Zhao-yu 2020, 18 (1):  10-16.  doi: 10.19438/j.cjoms.2020.01.002 Abstract ( 276 )   PDF (5279KB) ( 141 )   PURPOSE: To establish a cisplatin-resistant strain of tongue squamous cell carcinoma and observe whether it has tumor stem cell-like characteristics and whether epithelial-mesenchymal transition (EMT) occurs. METHODS: The cisplatin-resistant cell line of tongue squamous cell carcinoma was constructed by cisplatin gradient concentration method. The chemoresistance and tumor stem cell characteristics of tongue cisplatin-resistant strain and its parental cell line were compared by MTS, flow cytometry and balloon culture. The changes of factors related to tumor stem cell-like including SOX2, OCT4, BMI1 and ABCG2 were detected by qRT-PCR and Western blotting. The expression levels of EMT and E-cadherin and vimentin in tongue cancer cisplatin-resistant strains and their parental cell lines were detected by qRT-PCR and Western blot. Transwell modified chamber assay was used to study the invasion and migration ability of the two cell lines. The data were statistically processed using SPSS 17.0 software package. RESULTS: We successfully constructed two squamous cell carcinoma cisplatin-resistant strains CAL27-res and SCC9-res, and the two cell lines were more resistant to cisplatin. Compared with the parental cancer cells CAL27 and SCC9, CAL27-res and SCC9-res cells showed an interstitial phenotype, E-cadherin was down-regulated, vimentin and N-cadherin were up-regulated, and invasion and migration ability was enhanced. At the same time, CAL27-res and SCC9-res cells had enhanced balloon formation ability, tumor stem factors SOX2, OCT4, BMI1 and ABCG2 were up-regulated, and the proportion of CD44+/CD24- cells was increased. CONCLUSIONS: Cisplatin-induced tongue squamous cell carcinoma cells developed EMT and obtained tumor stem cell-like properties. References | Related Articles | Metrics

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Evaluation of the effect of tilted implant placement in patients with insufficient bone mass in maxillary posterior region JU Yun-meng, WU Na, NING Bo, YANG Fang, CHEN Zheng-gang, GUO Da-wei 2020, 18 (1):  17-21.  doi: 10.19438/j.cjoms.2020.01.003 Abstract ( 503 )   PDF (4195KB) ( 246 )   PURPOSE: To observe the clinical effect of tilted dental implants in patients with insufficient vertical bone mass in maxillary posterior region. METHODS: From January 2016 to June 2018,patients who were implanted and restored with residual bone height <6 mm in the maxillary posterior region were selected. Among them, 28 patients with titled implant (titled angle of 25°-35°) (40 implants) were recruited into group A; while 23 patients with transalveolar crest sinus floor elevation (34 implants) were recruited into group B. Kaplan-Meier survival analysis was used to evaluate the implant survival rate after implant restoration. Panoramic X-ray or cone-beam CT (CBCT) was taken pre- and post-operatively, and the average peripheral marginal bone resorption height of the implant was measured by image analysis and measurement software (Digimizer, Belgium). The data were analyzed with SPSS 24.0 software package. The follow-up period was 3 years after surgery, complications such as loose abutment, loosening of the restoration, collapse of porcelain or defect, food impaction were recorded after implantation. RESULTS: All implants were observed for a maximum of 3 years and a minimum of 1 year. The cumulative survival rate of group A was 100%, the cumulative survival rate of group B was 97.06% (one implant was detached before restoration), and there was no significant difference between group A and group B (P>0.05). There was no significant difference in the average marginal bone resorption height between group A and B (P>0.05). During the follow-up period, only three patients in group A developed horizontal food impaction, one patient had loose central screws, and no significant complications occurred in group B. CONCLUSIONS: For some patients with insufficient bone mass in maxillary posterior region, tilted implant placement has good clinical effect during the observation period of this study. References | Related Articles | Metrics

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Significance of neck dissection in Ⅱb area in early oral squamous cell carcinoma WU Hao, GONG Han-wen, WANG Gao-jun, TANG Qing-hua, HU Wen-ting, ZHANG Ling 2020, 18 (1):  22-27.  doi: 10.19438/j.cjoms.2020.01.004 Abstract ( 695 )   PDF (1143KB) ( 275 )   PURPOSE: To evaluate the clinical significance of selective cervical lymph node dissection in patients with oral squamous cell carcinoma without clinically cervical lymph node metastasis (cN0). METHODS: Between January 2012 and December 2014, 203 patients with cN0 who were treated in the Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, the average age was 59.7 (range:41-79) years, no other treatment was given before surgery. There were 127 males and 76 females. The primary sites were as followed: 101 in the tongue, 45 in the cheek, 30 in the floor of mouth, 19 in the gingiva, and 8 in other sites. According to postoperative pathological results, 203 patients were classified as T1 or T2, and all underwent primary lesion resection and supraomohyoid neck dissection (SOHND). One hundred and fifteen patients underwent Ⅱb level lymph node dissection, and the remaining 88 patients did not receive Ⅱb level lymph node dissection. The data of the two groups of patients were analyzed by independent sample t test with SPSS 22.0 software package. The analyzed indicators included incidence of complications (mainly scapular syndrome) and Ⅱb lymph node metastasis rate (mainly for the preserving Ⅱb group). Survival analysis was estimated by Kaplan-Meier method. RESULTS: In the Ⅱb level lymph node dissection group, 7(6.09%) patients were confirmed by postoperative pathology to have lymph node metastasis in the Ⅱb area. After 3 years of follow-up, 83(72.17%) patients had different degrees of scapular syndrome, and 27(32.53%) patients were relieved by rehabilitation training, but still not fully recovered. The 3-year overall survival of patients in Ⅱb level lymph node dissection group for 86.09%; in the control group, 4 patients (4.55%) developed scapular syndrome and recovered through rehabilitation after operation. The 3-year overall survival rate of the patients in the control group was 84.09%. There was no significant difference between the two groups (P>0.05). CONCLUSIONS: Patients with cN0 oral squamous cell carcinoma have a lower rate of cervical lymph node metastasis in the IIb level. Therefore, it is not necessary to excise the lymph nodes in the Ⅱb area when SOHND is performed, in order to protect the accessory nerve and its branches from damaging and improving the quality of life of the patients. References | Related Articles | Metrics

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Endoscopy-assisted transoral approach versus external approaches in resection of large benign parapharyngeal space tumors LIN Shi-geng, XU Xiong-jun, CHEN Yang, LI Jin-song, FAN Song 2020, 18 (1):  28-32.  doi: 10.19438/j.cjoms.2020.01.005 Abstract ( 440 )   PDF (3940KB) ( 149 )   PURPOSE: This study compared the clinical effects of endoscopy-assisted transoral approach (EATA) and external approaches (EAs) in the treatment of massive benign parapharyngeal space tumor. METHODS: Sixty-two patients with parapharyngeal space tumors(PSTs) were divided into EATA group and EA group. The perioperative and postoperative clinical data was statistically analysed using SPSS 21.0 software package. RESULTS: All tumors were completely removed. Six patients in EATA group switched to an extraoral approach during surgery. Eight patients in EA group underwent endoscopic surgery. The intraoperative blood loss, total drainage, postoperative pain score, and total length of hospital stay in EATA group were significantly less than those in EA group(P<0.05). The postoperative facial appearance satisfaction score was significantly higher in EATA group than that in EA group (P<0.05). CONCLUSIONS: Use of EATA to remove benign large tumors in the parapharyngeal space can reduce surgical trauma and obtain a better postoperative facial appearance. However, a combination of the two procedures can achieve better surgical results. References | Related Articles | Metrics

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Changes of temporomandibular joint space and condylar position in adolescents after arthroscopic disc repositioning surgery ZHAN Yi-ning, HU Ying-kai, MA Zhi-gui, YANG Chi 2020, 18 (1):  33-37.  doi: 10.19438/j.cjoms.2020.01.006 Abstract ( 661 )   PDF (3679KB) ( 296 )   PURPOSE: To compare the change of joint space and condylar position pre- and post-arthroscopic disc repositioning, and to investigate the influential factors as well as to provide useful information for surgical planning. METHODS: One hundred and thirty seven joints in 88 patients with anterior disc displacement treated with arthroscopic disc repositioning were included from January to December 2016. The widths of joint space in patients post-surgery were compared with those before surgery according to the follow-up results. Student's t test, Chi-square test and generalized additive models were used to assess the changes of joint spaces and condylar position with SPSS 17.0 and Empowerstats software package. RESULTS: The mean age at first visit was (16.40±2.14) years. The mean follow-up interval was (7.96±4.15) months. The average anterior space one week after surgery was (2.62±0.86)mm, (4.42±1.01)mm for the superior space, and (4.75±1.25)mm for the posterior space. The superior and posterior space increased significantly 1 week after arthroscopy, while the anterior space decreased significantly(P<0.05). The dominant condylar position changed from the centric(49.6%) to the anterior position(77.4%) postoperatively. Further more, the longer the follow-up time was, the more posterior the condylar position became. CONCLUSIONS: The superior space and posterior space increased significantly 1 week after arthroscopic surgery, and decreased as the following-up period got longer, but still with significant difference. References | Related Articles | Metrics

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Cone-beam CT measurement and analysis of micro-screw implantation sites in mandibular buccal area MAIMAITI·Tudi, HANIKEZI·Moming, MAIHEBUBAIMU·Tuerxun 2020, 18 (1):  38-41.  doi: 10.19438/j.cjoms.2020.01.007 Abstract ( 428 )   PDF (3143KB) ( 222 )   PURPOSE: Cone-beam CT (CBCT) was used to measure and analyze the regional sites of mandibular buccal shed for micro-screw implantation, providing guidance for dentists to safely place micro-screws. METHODS: Sixty-two patients receiving orthodontic treatment in our hospital were collected from January 2018 to October 2018. All patients underwent CBCT examination. Three-dimensional reconstruction of CBCT images was performed in the first premolar and 3 mm (D1), 6 mm (D2), 9 mm(D3) below the alveolar crest between the second premolar (A), the second premolar and the first molar (B), between the first molar and the second molar (C) for bone width, the differences in bone width between different genders, left and right side, and different positions were compared with SPSS 22.0 software package. RESULTS: The width of bone in different positions of the mandibular buccal shed in males and females was not significantly different between the left and right side (P>0.05). The bone width of the mandibular cheek shed area was significantly different at different distances and at the same distance (P<0.05). The width of bone at 9 mm of the alveolar crest between the first molar and the second molar was the largest [(10.62±1.38) mm], while the width of the bone at 3 mm of the alveolar crest of the second premolar and the first molar was the smallest [(2.65±0.38) mm]. CONCLUSIONS: The bone width of the mandibular buccal shed area was not significantly different in gender and between left and right side, but different anatomical sites in the mandibular cheek shed area had disparity, and there was an increasing trend from mesial to distal. References | Related Articles | Metrics

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A randomized controlled comparative study of King Vision and McGrath video laryngoscopes for nasotracheal intubation in patients with predicted difficult airways during oral and maxillofacial surgery ZHU Hao-zhen, SUN Yu 2020, 18 (1):  42-47.  doi: 10.19438/j.cjoms.2020.01.008 Abstract ( 411 )   PDF (4960KB) ( 132 )   PURPOSE: King Vision and McGrath MAC video laryngoscopes (VLs) are increasingly used. The purpose of this study was to evaluate the usefulness of nasotracheal intubation in patients with predicted difficult intubations using non-channeled King Vision VL, McGrath MAC VL or Macintosh laryngoscope by experienced intubators. METHODS: The study included 99 patients requiring nasal endotracheal intubation for elective oral and maxillofacial surgery with American Society of Anesthesiologists (ASA) classification of I or II and El-Ganzouri risk index 1-7. Three groups were randomly assigned to receive nasotracheal intubation by experienced anesthesiologists guided by non-channeled King Vision video laryngoscope (K group), McGrath video laryngoscope (M group), and Macintosh laryngoscope (C group). The intubation time, success rate of primary intubation, exposure time of glottis, view of glottis opening valued by Cormack-Lehane grade, hemodynamic changes (MAP, HR), number of assisted maneuvers and incidence of side effects were recorded and compared with GraphPad Prism 5.0 software package. RESULTS: The intubation time of King Vision and McGrath group was comparable (37.6±7.3 seconds vs. 35.4±8.8 seconds) and both were significantly shorter than Macintosh group (46.8±10.4 seconds, P<0.001). Both King Vision and McGrath groups had a 100% first attempt success rate, significantly higher than Macintosh group (85%, P<0.05). The laryngoscopy time was comparable between King Vision and McGrath group (16.7±5.5 seconds vs. 15.6±6.3 seconds) and was significantly shorter than Macintosh group (22.8±7.2 seconds, P<0.05). Compared with Macintosh laryngoscope, Glottis view was obviously improved when exposed with either non-channeled King Vision or McGrath MAC VL (P<0.001), and assist maneuvers required were reduced (P<0.001). The maximum fluctuations of MAP were significantly attenuated in VL group [(47.7±12.5) mmHg and (45.1±10.3) mmHg vs. (54.9±10.2) mmHg, P<0.05 and P<0.01). Most device insertions were graded as excellent in McGrath group, followed by Macintosh and King Vision group (P=0.0014). The tube advancements were easier in VLs compared with Macintosh laryngoscope (P<0.001). Sore throat was found more frequent in Macintosh group compared with King Vision group (P<0.05). CONCLUSIONS: Compared with Macintosh laryngoscope, both King Vision and McGrath video laryngoscopes facilitated nasotracheal intubation in managing predicted difficult airways during oral and maxillofacial surgery. References | Related Articles | Metrics

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Effect of different thermal insulation measures on the recovery from general anesthesia in patients with head and neck tumor LIN Yu, JIANG Jue, LYU Xiang 2020, 18 (1):  48-50.  doi: 10.19438/j.cjoms.2020.01.009 Abstract ( 292 )   PDF (2488KB) ( 211 )   PURPOSE: To study the effect of different thermal insulation measures on the recovery from general anesthesia in patients with head and neck tumor. METHODS: One hundred and twenty-five patients with head and neck tumor under general anesthesia from October 2017 to October 2018 were selected. According to the thermal insulation measures used during operation, the patients were divided into four groups: normal temperature group (group A, 31 patients), thermal insulation blanket group(group B, 36 patients), liquid heating meter group (group C, 32 patients) and integrated group (group D, 26 patients). Changes in blood pressure, body temperature, heart rate,extubation time, conscious recovery time and incidence of complication were compared among the four groups. The data were analyzed using GraphPad Prism 5 software package. RESULTS: During the recovery phase, changes in body temperature, heart rate and blood pressure were significantly lower in group B, C and D than in group A, and lowest in group D (P﹤0.05). Extubation time and recovery time was significantly lower in group B, C and D than in group A, and lowest in group D (P﹤0.05). The incidence of complications was significantly lower in group B, C and D than in group A, and lowest in group D (P﹤0.05). CONCLUSIONS: Thermal insulation measures, especially integrated thermal insulation, can significantly improve the quality of anesthesia recovery, reduce the incidence of complications and improve the safety of anesthesia recovery. References | Related Articles | Metrics

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Comparison among dexmedetomidine, propofol and midazolam for sedation in patients with intubation after oral and maxillofacial surgery WANG Li, ZHANG Tie-jun, PENG Wei 2020, 18 (1):  51-55.  doi: 10.19438/j.cjoms.2020.01.010 Abstract ( 421 )   PDF (3706KB) ( 91 )   PURPOSE: Due to adjacent to the airway, oral and maxillofacial surgery is more common and serious to have emergency airway than other surgeries. The aim of this study was to clarify the beneficial sedative effects for patients with postoperative intubation in the intensive care unit (ICU) after oral and maxillofacial surgery. METHODS: Sixty patients with postoperative intubation were divided into 3 groups using random number table: midazolam group, propofol group and dexmedetomidine group. Ramsay score, behavioral pain scale(BPS) score, SpO2, HR, MAP, and RR were recorded before sedation, 30 min(T1), 1 h(T2), 2 h(T3), 6 h(T4), and 12 h(T5) after sedatives initiation in ICU, and 10 min after extubation (T6). The rate of incidences of side effects was calculated. The data were analyzed with SPSS 19.0 software package. RESULTS: Midazolam, dexmedetomidine and propofol had similar sedative effect. BPS score in dexmedetomidine group was significantly lower than that in propofol group and midazolam group at time point of T3, T4 and T5 (P<0.05). The incidence of bradycardia in dexmedetomidine group was significantly higher than that in midazolam group and propofol group (P<0.05). There was no significant difference in the incidence of hypotension among 3 groups (P>0.05). The number of restlessness in dexmedetomidine group and propofol group was significantly lower than that in midazolam group(P<0.05). CONCLUSIONS: Dexmedetomidine and midazolam can meet the needs for sedation in ICU patients. Dexmedetomidine can improve patients' ability to communicate pain compared with midazolam. References | Related Articles | Metrics

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Blood biochemical indexes and bone regeneration in 50 children with cleft lip and palate before and after operation YAO Zhi-tao, AN Wei, MAIMAITITUXUN·Tuerdi 2020, 18 (1):  56-59.  doi: 10.19438/j.cjoms.2020.01.011 Abstract ( 393 )   PDF (3154KB) ( 203 )   PURPOSE: To study the changes of blood biochemical indexes before and after operation in 50 children with cleft lip and palate and the effect of operation on bone regeneration in cleft palate. METHODS: From April 2014 to April 2016, 50 patients with cleft lip and palate were included. All children were treated surgically. The ratio of white blood cells, platelets, plasma albumin and globulin (hereinafter referred to as white blood cell ratio), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were compared, and the difference of the width of the anterior segment, middle segment, posterior segment width, the area of palate, the width of the cleft lip, the width of the alveolar process, the sagittal distance, the horizontal distance, the inclination of the maxillary protrusion and the fissure area were compared with SPSS 19.0 software package. RESULTS: The white blood cells, platelets, plasma albumin and globulin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly lower than those before operation (P<0.05). The positive rate of regenerated bone bridge after operation was 80.0%. The average length and width of regenerated bone bridge were (12.3±3.6) mm and (12.3±2.3) mm, respectively. The average width of anterior arch, middle arch and posterior arch were (31.6±2.9) mm, (41.2±6.2) mm and (51.6±6.9) mm, respectively, which were significantly smaller than those before surgery (P<0.05). There were significant differences in area of palate, width of cleft palate, sagittal distance of alveolar fissure, horizontal distance, inclination of anterior maxillary process, area of fissure before and after operation (P<0.05). CONCLUSIONS: The changes of blood biochemical indexes are obvious in children with cleft lip and palate after operation. The formation of regenerative bone bridge in upper palate fissure is beneficial to the development of dental arch and maxilla in children with cleft lip and palate. References | Related Articles | Metrics

Clinical Reports

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Usefulness of Introducer technique for percutaneous endoscopic gastrostomy in patients with upper digestive tract stenosis WU Jia-jun, WANG Fan-lin, GE Wei-wen, FAN Jing-xian, ZENG Li-ting, WANG Qi, XIE Ting, ZHANG Lin, XU Bing, GE Kui 2020, 18 (1):  60-63.  doi: 10.19438/j.cjoms.2020.01.012 Abstract ( 333 )   PDF (3173KB) ( 286 )   PURPOSE: To describe our experiences with Introducer technique for percutaneous endoscopic gastrostomy in patients with upper digestive tract stenosis. METHODS: A retrospective analysis was conducted in 61 patients with Introduce-PEG from January 2016 to December 2018. The gastric lumen was dilated by injection of room air through transnasal ultrathin gastroscopy, nasogastric tube, or fine needle, and introduce gastrostomy procedures were divided into two kinds according the procedure guided by transnasal ultrathin gastroscopy or CT. RESULTS: Among 61 patients, 60 finished surgery successfully, 1 patient failed. Fifty-two patients were dilated by transnasal ultrathin gastroscopy and 4 patients by nasogastric tube successfully. Among 5 patients dilated by fine needle, one patient failed for the reason of dilating the gastric wall. No complications were observed by transnasal ultrathin gastroscopy guided PEG. One patient had postoperative bleeding during CT guided gastrostomy. CONCLUSIONS: Introduce-PEG is an effective technique to establish nutritional channel for patients with upper digestive tract stenosis. Transnasal ultrathin gastroscopy can monitor the procedure real time, and will be more safety than CT guided PEG. References | Related Articles | Metrics

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Repair of donor site defect after forearm free flap harvest with dual triangular flaps and in situ small full thickness skin flaps YAO Lin, GUO Meng-meng, DENG Zhang, ZENG Wei 2020, 18 (1):  64-67.  doi: 10.19438/j.cjoms.2020.01.013 Abstract ( 347 )   PDF (3109KB) ( 202 )   PURPOSE: To introduce a method of repairing donor site defect after forearm free flap harvest with dual triangular flaps combined with in situ small full thickness skin flaps. METHODS: Free forearm skin flaps were applied for repairing defects after tumor resection in 25 patients with oral squamous cell carcinoma. In order to repair the donor site defect in situ, the dual triangular flaps and adjacent full-thickness skin flaps were designed and fabricated while the forearm free flaps were prepared. RESULTS: Twenty-five cases with forearm donor site defects were successfully repaired with dual triangular flaps combined with in situ small full thickness skin grafts. All the adjacent full-thickness skin grafts used to close the donor site defect of forearm survived, and the wound healed well without delayed wound rupture and serious complications. The movement of elbow and wrist joint on the side of the flap was normal, blood supply in the palm was normal, and the skin color of the donor site of the forearm skin flap was similar to the surrounding tissue. There was no deficiency or contracture deformity. Moreover, compared with the abdominal skin grafting group, there was no significant difference in swelling and wrist movement between the forearm adjacent skin grafting group and the abdominal skin grafting group, but the former technique reduced the risk of scar infection and tendon exposure, and greatly improved the aesthetics of the donor site. CONCLUSIONS: Modified donor dual triangular flaps combined with adjacent full thickness skin graft can reduce the recovery time during and after operation and avoid the trauma in the third operation area. It is worthy of practical application in the preparation of forearm skin flaps in oral and maxillofacial surgery. References | Related Articles | Metrics

Dental Education

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Application of three-dimensional reconstruction technique in clinical teaching of mandibular third molar extraction LIU Zhi-yang, CHEN Min-jie, ZHANG Wei-jie, WEI Wen-bin, HAN Zi-xiang, CHAI Ying 2020, 18 (1):  68-70.  doi: 10.19438/j.cjoms.2020.01.014 Abstract ( 408 )   PDF (2276KB) ( 212 )   PURPOSE: To explore the application of three-dimensional reconstruction technique in clinical teaching of impacted tooth extraction. METHODS: Using the three-dimensional reconstruction software Mimics 20.0, the positional relationship between the mandibular third molar and the surrounding tissues, including the adjacent teeth, the inferior alveolar nerve canal and the surrounding jaw bone, were presented in three dimensions. Among the interns of Shanghai Jiao Tong University College of Stomatology, 40 students were randomly divided into two groups: the three-dimensional reconstruction study group and the traditional teaching group, 20 students in each group. The clinical teaching of impacted tooth extraction was performed separately, and the students were subjected to theoretical assessment, comprehensive practice assessment and questionnaire survey after completion of the teaching course. The data were analyzed with SPSS 23.0 software package. RESULTS: There was no significant difference in the theoretical assessment between the two groups of students, but the three-dimensional reconstruction teaching group was significantly better than the traditional teaching group in comprehensive ability assessment. Questionnaire survey showed that students in the 3D reconstruction teaching group were more satisfied with the learning results than the traditional teaching group. CONCLUSIONS: Clinical teaching through 3D reconstruction technology has deepened the students' understanding of the theoretical knowledge and local anatomy of impacted teeth, and has improved the students' interest in learning. Therefore, 3D reconstruction technology has broad application prospects in the clinical teaching of impacted tooth extraction, which can greatly improve the quality of clinical teaching. References | Related Articles | Metrics

Review Articles

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Research advances in the mechanism of malignant progression of oral submucous fibrosis ZHANG Da-he, ZHOU Shang-hui 2020, 18 (1):  71-76.  doi: 10.19438/j.cjoms.2020.01.015 Abstract ( 590 )   PDF (5029KB) ( 223 )   Oral submucosal fibrosis is one of the precancerous lesions of oral squamous cell carcinoma. The process of its malignant transformation is complex and its malignant mechanism is still unclear. In this paper, the latest research progress on the mechanism of OSF malignant transformation was reviewed, including chewing areca nut and OSF malignant progression, hypoxia and angiogenesis, epithelial mesenchymal transformation and epigenetic regulation. References | Related Articles | Metrics

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Polidocanol sclerotherapy for hemangiomas and vascular malformations: an up-to-date advance ZHANG Han-shu, LIU Shao-hua, ZHENG Jia-wei 2020, 18 (1):  77-81.  doi: 10.19438/j.cjoms.2020.01.016 Abstract ( 973 )   PDF (4340KB) ( 446 )   Hemangiomas and vascular malformations are common diseases with a prevalence about 40%-60% in head and neck, which can cause significant aesthetic and functional problem, even leading to death. The treatment of complex hemangiomas and vascular malformations remain a global challenge. The current treatment strategy mainly include surgical resection, sclerotherapy, laser therapy and endovascular interventional therapy. As an effective method for venous malformations and lymphatic malformations, sclerotherapy has been gradually used in treating hemangiomas and pyogenic granuloma. Polidocanol is one of the sclerosing agents widely used worldwide. This article reviewed the background and up-to-date advances of polidocanol in treating hemangiomas and vascular malformations. References | Related Articles | Metrics

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Progress of diagnosis and treatment for congenital hemangioma ZHANG Chong, MAI Hua-ming 2020, 18 (1):  82-86.  doi: 10.19438/j.cjoms.2020.01.017 Abstract ( 475 )   PDF (4237KB) ( 213 )   Congenital hemangiomas are uncommon vascular tumors. They are present at birth, and divided into three categories: rapidly involuting congenital hemangiomas (RICH), noninvoluting congenital hemangiomas (NICH) and partially involuting congenital hemangiomas (PICH). Clinical, imaging, and histopathological examinations are used for diagnosis and differential diagnosis with other similar diseases. Moreover, treatment is different for lesions. How to diagnose more accurately and treat these lesions effectively is the focus of recent research in this field. This paper reviewed the progress of diagnosis and treatment of congenital hemangiomas based on reviewing relevant domestic and foreign literatures. References | Related Articles | Metrics

Case Reports

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Mandibular mass as the initial presentation of renal clear cell carcinoma: report of two cases and literature review YANG Yang, PANG Chao-yuan, ZHANG Wen-kai, MA Dong-yang 2020, 18 (1):  87-90.  doi: 10.19438/j.cjoms.2020.01.018 Abstract ( 474 )   PDF (3236KB) ( 267 )   Renal clear cell carcinoma (RCC) metastasizes in early stage, but it is infrequent to metastasize to the head and neck. This paper reported two RCC cases with mandibular mass as the initial presentations. The clinical incidence and features of RCC, including radiological characteristics and pathological examination were reviewed, in order to provide more information for avoiding misdiagnosis and selecting appropriate treatment. References | Related Articles | Metrics

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Analysis of 2 dead cases due to upper gastrointestinal bleeding after flap reconstruction of defects resulting from resection of head and neck tumor WANG Shao-jie, ZHANG Rui, YANG Tao, WANG Wei-qi, WEI Jian-hua 2020, 18 (1):  91-93.  doi: 10.19438/j.cjoms.2020.01.019 Abstract ( 513 )   PDF (2561KB) ( 255 )   Upper gastrointestinal hemorrhage is a common clinical emergency, with the incidence of acute episodes ranging from (60-150)/100 000 people per year and the mortality ranging from 5%-10%. As more and more free flap transplantations are carried out in different units, it is mandatory to strength the understanding of upper digestive tract bleeding complications after transplantation to reconstruct surgical defects among oral and maxillofacial surgeons. This paper reported 2 dead cases due to acute upper gastrointestinal bleeding, discussed the causes and measures for prevention and treatment, with the aim to care the patient's vital interests, and improve the quality of medical management. References | Related Articles | Metrics

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Treatment of nevoid basal cell carcinoma syndrome with free forearm flap: a case report PANG Chao-yuan, MA Dong-yang, ZHANG Wen-kai, TIAN Wen-yan 2020, 18 (1):  94-96.  doi: 10.19438/j.cjoms.2020.01.020 Abstract ( 402 )   PDF (2187KB) ( 361 )   This case report presented a 30-year-old male with mandibular skin defect for more than 3 months. The pathological examination indicated basal squamous cell carcinoma. Treatment included jaw cysts enucleation, mandibular soft tissue and bone lesion resection, and free forearm flap was used to repair soft and hard tissue defects. The patient recovered well after operation. References | Related Articles | Metrics