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20 September 2022, Volume 20 Issue 5 Previous Issue    Next Issue

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CONTENTS 2022, 20 (5):  0-0.  Abstract ( 123 )   PDF (445KB) ( 90 )   Related Articles | Metrics

Expert Consensus

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Ultrasonography diagnosis of head and neck vascular malformations GONG Xia, LI Jia, XIONG Ping, DING Ang-ang 2022, 20 (5):  417-421.  doi: 10.19438/j.cjoms.2022.05.001 Abstract ( 292 )   PDF (2068KB) ( 130 )   Ultrasound is a non-invasive and convenient tool for auxiliary diagnosis of head and neck vascular malformations, preoperative evaluation and follow-up of disease changes. Ultrasound technologies include grayscale imaging, color Doppler and spectral Doppler imaging. This article summarized the ultrasound examination methods of these lesions based on the new classification of vascular diseases proposed by International Society for the study of Vascular Anomalies(ISSVA), and reviewed the relevant clinical and ultrasound features of various malformations, in order to provide an effective basis for clinical diagnosis and treatment. References | Related Articles | Metrics

Original Articles

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Long-term performance of dental implants in vascularized iliac crest grafts for mandibular reconstruction in 14 consecutive patients GU Yu-wei, WANG Feng, HUANG Wei, ZHANG Zhi-yong, ZHANG Chen-ping, SUN Jian, WU Yi-qun 2022, 20 (5):  422-428.  doi: 10.19438/j.cjoms.2022.05.002 Abstract ( 270 )   PDF (2039KB) ( 196 )   PURPOSE: To evaluate the long-term performance of dental implants installed in vascularized iliac crest grafts for mandibular reconstruction by clinical and radiographic examinations. METHODS: From 1995 to 2005, 47 implants installed in vascularized iliac crest grafts for mandibular reconstruction in 14 patients were analyzed, including 30 implants immediately placed into vascularized iliac crest grafts in 10 patients and 17 implants placed later in 4 patients. The cumulative survival rate within 15 years of dental implants and prostheses was evaluated. Clinical assessments and radiographic examination were performed 5 years and 10 years after implant loading. Statistical analysis was performed using SPSS 26.0 software package. RESULTS: No early failures occurred during the healing period. Cumulative survival rates of implants for 10 years and 15 years were 90.44% and 86.67% and cumulative survival rate of prostheses for 15 years was 78.32%, respectively. The average marginal bone loss at 5 years was (2.08±0.27) mm, while that at 10 years was (4.22±0.48) mm (P<0.0001). Biological complications were peri-implantitis and soft tissue hyperplasia, and mechanical complication was abrasion of the prostheses mainly. CONCLUSIONS: The long-term performance of dental implants installed in vascularized iliac crest grafts for mandibular reconstruction is stable, which is an effective method for mandibular defect reconstruction, but the incidence of peri-implantitis is relatively higher. So, maintaining the stability of soft and hard tissues around the implant is a crucial guarantee for the long-term performance of implants. References | Related Articles | Metrics

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Comprehensive co-expression analysis revealed NLRP1 as a prognostic immune-associated gene in head and neck squamous cell carcinoma YANG Hui-li, WANG Yu-fan, WANG Feng, SHEN Yue-hong, YANG Hong-yu 2022, 20 (5):  429-436.  doi: 10.19438/j.cjoms.2022.05.003 Abstract ( 329 )   PDF (2408KB) ( 108 )   PURPOSE: To explore the prognostic value and mechanism of NLR family, pyrin domain containing 1 (NLRP1) in head and neck squamous cell carcinoma(HNSCC). METHODS: This study performed bioinformatics analysis on HNSCC data from The Cancer Genome Atlas (TCGA), and jointly analyzed with online databases such as TIMER, TCGAportal, Kaplan-Meier Plotter, LinkedOmics, GeneMANIA, Metascape, TISIDB and miRDB. RESULTS: NLRP1 was up-regulated in HNSCC. Kaplan-Meier survival analysis indicated that patients with high NLRP1 expression had a better prognosis than those with low expression. Furthermore, NLRP1 was concentrated in multiple immune-associated signaling pathways and the expression of NLRP1 was associated with the infiltration of CD4+ T cells, neutrophils and dendritic cells. CONCLUSIONS: Our findings confirmed that NLRP1 is highly expressed in HNSCC. The high expression of NLRP1 was significantly related to prognosis and the infiltration degree of CD4+ T cells, neutrophils and dendritic cells in HNSCC. References | Related Articles | Metrics

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Characteristics of adolescent patients with temporomandibular joint anterior disc displacement ZHANG Da-he, SHEN Pei, YANG Chi 2022, 20 (5):  437-442.  doi: 10.19438/j.cjoms.2022.05.004 Abstract ( 477 )   PDF (1494KB) ( 117 )   PURPOSE: To Summarize the characteristics of patients with temporomandibular joint (TMJ) anterior disc displacement (ADD) in our department. METHODS: Consecutive patients first diagnosed with TMJ ADD in the TMJ Clinic at Department of Oral Surgery in Shanghai Ninth People's Hospital from April 2015 to November 2018 were included in this study. Demographic information, first visit department, chief complaints, history of present illness, past history, clinical characteristics and diagnosis of the patients were collected. The data was analyzed by SPSS 21.0 software package. RESULTS: A total of 743 ADD patients were enrolled during the observation period, and the male to female ratio was 1:5.52. Among them, patients ≤20 years old accounted for the highest proportion (58.0%), and the peak age of the visited population was 15-16 years old. Compared with adult patients, adolescent patients ≤ 20 years old had a higher proportion of patients who first visited orthodontic (or orthognathic) department due to the chief complaint of dentofacial deformity (P<0.001), a higher proportion of patients with bruxism(P<0.001), and lower proportions of patients with preauricular pain, mandibular deviation or who were diagnosed as idiopathic condylar resorption (all P<0.01). In the adolescent patients ≤ 20 years, patients who first visited orthodontic (or orthognathic) department due to the chief complaint of dentofacial deformity had lower proportions of patients with preauricular pain or restricted mouth opening (P<0.01), and a higher proportion of patients with mandibular retraction(P<0.001). CONCLUSIONS: Adolescents with TMJ ADD have much higher demand for treatment than other age groups. A considerable number of them present the main complaint of dentofacial deformities and have milder symptoms, but they do not understand the relationship between TMJ diseases and dentofacial deformities, which might delay the best treatment opportunity. References | Related Articles | Metrics

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Characteristics of adolescent patients with temporomandibular joint anterior disc displacement ZHANG Da-he, SHEN Pei, YANG Chi 2022, 20 (5):  443-448.  doi: 10.19438/j.cjoms.2022.05.005 Abstract ( 292 )   PDF (619KB) ( 100 )   PURPOSE: To Summarize the characteristics of patients with temporomandibular joint (TMJ) anterior disc displacement (ADD) in our department. METHODS: Consecutive patients first diagnosed with TMJ ADD in the TMJ Clinic at Department of Oral Surgery in Shanghai Ninth People's Hospital from April 2015 to November 2018 were included in this study. Demographic information, first visit department, chief complaints, history of present illness, past history, clinical characteristics and diagnosis of the patients were collected. The data was analyzed by SPSS 21.0 software package. RESULTS: A total of 743 ADD patients were enrolled during the observation period, and the male to female ratio was 1:5.52. Among them, patients ≤20 years old accounted for the highest proportion (58.0%), and the peak age of the visited population was 15-16 years old. Compared with adult patients, adolescent patients ≤ 20 years old had a higher proportion of patients who first visited orthodontic (or orthognathic) department due to the chief complaint of dentofacial deformity (P<0.001), a higher proportion of patients with bruxism(P<0.001), and lower proportions of patients with preauricular pain, mandibular deviation or who were diagnosed as idiopathic condylar resorption (all P<0.01). In the adolescent patients ≤ 20 years, patients who first visited orthodontic (or orthognathic) department due to the chief complaint of dentofacial deformity had lower proportions of patients with preauricular pain or restricted mouth opening (P<0.01), and a higher proportion of patients with mandibular retraction(P<0.001). CONCLUSIONS: Adolescents with TMJ ADD have much higher demand for treatment than other age groups. A considerable number of them present the main complaint of dentofacial deformities and have milder symptoms, but they do not understand the relationship between TMJ diseases and dentofacial deformities, which might delay the best treatment opportunity. References | Related Articles | Metrics

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Relationship between postoperative lingual nerve dysfunction and quality of life in oral cancer patients WU Zi-qian, YIN Yu-lan, YANG Wen-yu, ZHANG Zhen, HOU Li-li, WANG Lei 2022, 20 (5):  449-454.  doi: 10.19438/j.cjoms.2022.05.006 Abstract ( 461 )   PDF (826KB) ( 153 )   PURPOSE: To investigate the oral function and quality of life of patients presenting with lingual nerve injury after radical surgery for oral cancer by means of a self-administered questionnaire, to provide a basis for the clinical management of patients with lingual nerve injury. METHODS: Through qualitative sensory analysis of 350 patients, forty patients with tongue sensory numbness were screened out, and the questionnaire was conducted by self-made Rehabilitation Questionnaire of Tongue Sensory Dysfunction. RESULTS: According to the results, the 5 most common manifestations of tongue sensory dysfunction were ①fear of not recovering from altered sensation; ② difficulty in making expressions that require tongue involvement; ③difficulty in speaking; ④inability to be aware of food residue on the floor of the mouth or tongue to maintain oral hygiene; ⑤difficulty in sleeping due to altered tongue sensation. CONCLUSIONS: The decline in quality of life due to tongue sensory dysfunction is multifaceted and oral and maxillofacial surgery providers should enhance the perioperative assessment and management of lingual nerve injury. References | Related Articles | Metrics

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Effect of transcutaneous electrical acupoint stimulation on myelosuppression in patients with oral squamous cell carcinoma after induction chemotherapy JI Ping-ping, LI Li, WU Yi-fan, HOU Li-li 2022, 20 (5):  455-460.  doi: 10.19438/j.cjoms.2022.05.007 Abstract ( 337 )   PDF (792KB) ( 146 )   PURPOSE: To observe the effect of transcutaneous electrical acupoint stimulation on myelosuppression in patients with oral squamous cell carcinoma (OSCC) after induction chemotherapy. METHODS: A total of 94 patients with OSCC who received docetaxel, cisplatin, and 5-fluorouracil induction chemotherapy for the first time were selected and randomly divided into the experimental group and the control group, with 47 cases in each group. Patients in the experimental group were given transcutaneous electrical acupoint stimulation intervention on the basis of conventional treatment, while patients in the control group were given placebo/sham stimulation on the basis of conventional treatment, and were intervened for two cycles of chemotherapy. The counts of white blood cells, hemoglobin, platelets and neutrophils, the grades of myelosuppression, the use of anti-myelosuppressive drugs and the scores of fatigue status were compared between the two groups of patients during the two chemotherapy cycles. SPSS 25.0 software package was used for data analysis. RESULTS: In the second chemotherapy cycle, the hemoglobin, platelet and neutrophil counts on the 6th day of chemotherapy and the platelet count on the 13th day of chemotherapy in the experimental group were significantly higher than those in the control group(P<0.05). In the second chemotherapy cycle, the difference of myelosuppression grades between the two groups was statistically significant(P<0.05), the severity of patients in the experimental group was significantly lower than that in the control group. There was no significant difference in the use of anti-myelosuppressive drugs between the two groups of patients during the two chemotherapy cycles(P>0.05). The total score of fatigue in the experimental group was significantly lower than that in the control group on the 13th day of the first chemotherapy cycle, one day before the second chemotherapy cycle, on the 6th and 13th day of chemotherapy, and the differences were statistically significant(P<0.05). CONCLUSIONS: Transcutaneous electrical acupoint stimulation can help to stabilize the blood index count level of OSCC patients after chemotherapy, reduce the severity of myelosuppression, and relieve their fatigue symptoms. References | Related Articles | Metrics

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Comparison of reliability of 5 evaluation methods for intraoral tonsil hypertrophy in awake and anesthetized individuals YAO Kan, XIE Yi-lun, YU Wen-wen, WEI Si-long, XIA Liang, ZHENG Tong, LU Xiao-feng 2022, 20 (5):  461-465.  doi: 10.19438/j.cjoms.2022.05.008 Abstract ( 569 )   PDF (861KB) ( 226 )   PURPOSE: To determine the reliability of the 5 clinical grading scales of tonsillar size in reporting the size of tonsils in awake and anesthetized individuals. METHODS: Awake and anesthetized tonsillar images of 218 patients aged 3 to 14 years with no severe craniofacial abnormalities were retrospectively collected. For each patient, five separate tonsil assessments were conducted by 3 experienced experts. Intraclass correlation coefficients(ICC) and Cronbach's α were used to determine the reliability of tonsil size in awake and anesthetized state. Statistical analysis was performed with R language (version 3.6.3). RESULTS: The reliability was highest for traditional 3-grade scale (ICC, 0.58; Cronbach's α, 0.74), followed by Friedman grading scale (ICC, 0.57; Cronbach's α, 0.73), modified 3-grade scale (ICC, 0.57; Cronbach's α, 0.72), modified 5-grade scale(ICC, 0.42; Cronbach's α, 0.59) and Brodsky grading scale(ICC, 0.30; Cronbach's α, 0.46). CONCLUSIONS: The tonsils tended to be underestimated when the individuals were awake, while the 5 tonsil assessments were able to figure out the real volume of tonsils respectively. References | Related Articles | Metrics

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Accuracy of detachable 3D-printed stent placement in radiotherapy for oral cancer patients FAN Wen-hui, LAO Zheng, SHI Hui-feng, BI Fan, TU Wen-yong, HU Hai-sheng 2022, 20 (5):  466-470.  doi: 10.19438/j.cjoms.2022.05.009 Abstract ( 467 )   PDF (908KB) ( 220 )   PURPOSE: To customize a detachable 3D-printed oral stent for patients with oral cancer radiotherapy, the stent was connected with thermoplastic film to improve the positioning accuracy of patients. METHODS: Twenty patients with oral cancer were randomly divided into control group and experimental groups, patients in the experimental group used detachable 3D-printed stents placement while patients in the control group used traditional 3D-printed oral stents. X1, Y1, Z1 direction of translation and X2, Y2, Z2 direction of rotating beam position error were obtained by cone-beam CT (CBCT) in patients before (1st radiotherapy), during (10th radiotherapy), and after radiotherapy (20th radiotherapy). The positioning errors of the third cervical spine and the horizontal ramus of the mandible were evaluated for clinical positioning errors. SPSS 23.0 software package was used for data analysis. RESULTS: The mean translational errors in X1, Y1 and Z1 directions were (0.120±0.083), (0.180±0.250), (0.170±0.150) cm in the control group, and (0.081±0.084), (0.047±0.059) , (0.046±0.036) cm in the experimental group. The difference was statistically significant in the Y1(t=2.4, P<0.05) and Z1(t=3.64, P<0.05) direction. The mean rotational positioning errors of X2, Y2 and Z2 were 1.04°±0.62°, 1.26°±1.30°, 0.65°±0.55° in the control group and 0.67°±0.73°, 0.54°±0.24°, 0.45°±0.37° in the experimental group. The difference was statistically significant in the direction of Y2(t=2.53, P<0.05). The displacement of the third cervical vertebra in the control group and the experimental group was (0.130±0.080) and (0.074±0.090) cm. The displacement at the end point of the horizontal ramus of the mandible was (0.240±0.180) cm in the control group and (0.095±0.065) cm in the experimental group, which had significant difference (t=2.99, P<0.05). CONCLUSIONS: Compared with traditional 3D printed oral stent, the detachable 3D printed oral stent can effectively improve the positioning accuracy and has a good clinical application prospect. References | Related Articles | Metrics

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Construction and validation of early warning model for postoperative infection of radionecrosis of the jaw LIU Shu-chang, ZHANG Zhao-qiang, HUANG Hong-zhang, LIU Xi-qiang 2022, 20 (5):  471-476.  doi: 10.19438/j.cjoms.2022.05.010 Abstract ( 350 )   PDF (874KB) ( 101 )   PURPOSE: The purpose of this study was to construct a rosette model to predict the risk of surgical site infection (SSI) after surgical treatment of osteoradio-necrosis of the jaw (ORNJ), and to conduct external validation of the model to evaluate its predictive power. METHODS: Five hundred and seven ORNJ surgical cases from March 1993 to October 2014 in Hospital of Stomatology, Sun Yat-sen University were included as model group. In addition, 112 ORNJ surgical cases from January 2000 to November 2021 in Hospital of Stomatology, Southern Medical University were included as validation group. The patients' clinical data were collected. Univariate and multivariate Logistic regression model in SPSS 22.0 software package was used to analyze the contributing factors of patients of ORNJ complicated with SSI. Then a nomogram was established using R programming language to predict the risk of ORNJ being complicated with SSI, internal and external validations were finally carried out. RESULTS: Logistic regression analysis showed that gender, radiation interval (≤2 years), mouth opening(≤1 cm), preoperative infection and procedures were the independent contributing factors of ORNJ complicated with SSI. Harrell concordance index was 0.745 and 0.751 in model group and in validation group, respectively. Calibration curve showed that this model had good discrimination and accuracy. The area under the curve (AUC) of ROC was 0.7446(95%CI: 0.6934-0.7959) and 0.7514(95%CI: 0.6556-0.8473) in model group and in validation group, respectively for predicting the risk of ORNJ complicated with SSI. CONCLUSIONS: Nomogram combining factors like gender, radiation interval, mouth opening, preoperative infection and operation methods can provide us with a comparatively precise way to predict the risk of surgical site infection in patients with ORNJ during perioperative period, which has distinct clinical application value. References | Related Articles | Metrics

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Expression and clinical significance of aquaporin 3 in oral mucosal epithelial dysplasia and oral squamous cell carcinoma XU Gang, SONG Qi-yi, JIANG Wei-dong, LIU Jing-xiu 2022, 20 (5):  478-482.  doi: 10.19438/j.cjoms.2022.05.011 Abstract ( 316 )   PDF (705KB) ( 137 )   PURPOSE: To explore the expression and clinical significance of aquaporin 3 (AQP3) in oral squamous cell carcinoma(OSCC). METHODS: Two hundred and two oral mucosal tissue paraffin specimens were collected in Panjin Liaoyou Baoshihua Hospital from March 2014 to April 2017. Among them, forty-one healthy volunteers (control group) and 45 oral mucosal epithelial abnormalities (group A) , one hundred and sixteen cases of OSCC(group B) were included. The expression of AQP3 in oral mucosa tissue of the 3 groups was detected by immunohistochemical staining. The relationship between AQP3 expression and clinicopathological factors and prognosis of OSCC were analyzed. SPSS 18.0 software package was used for data analysis. RESULTS: The positive expression rate of AQP3 in group B was significantly higher than that of group A and control group (P<0.05), and AQP3 positive expression rate in oral mucosa tissues of group A was significantly higher than that of the control group(P<0.05). AQP3 positive expression rate in OSCC patients with tumor invasion depth> 5 mm, clinical T4 staging, cervical lymph node metastasis, and poorly differentiated patients were respectively higher than that in patients with tumor invasion depth≤5 mm, clinical T2 staging, no cervical lymph node metastasis, moderately well differentiated patients (P<0.05). The 3-year survival rate of OSCC patients with positive AQP3 expression(65.85%) was significantly lower than patients with negative AQP3 expression(90.00%, P<0.05). Cox regression analysis showed that tumor clinical stage, degree of differentiation, cervical lymph node metastasis, and AQP3 positive expression rate are independent prognostic factors that affect overall survival (P<0.05). CONCLUSION: The positive expression rate of AQP3 in oral mucosal tissues of OSCC patients is higher than that in patients with oral mucosal epithelial dysplasia. The expression of AQP3 is related to clinical stage, cervical lymph node metastasis, degree of differentiation, depth of tumor invasion and overall survival rate in OSCC patients. References | Related Articles | Metrics

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The value of maxillary sinus width and angle in predicting the stability of maxillary sinus floor lifting via alveolar crest ZHU Ting, ZHOU Wu, ZHUANG Gui-jing, KANG Cheng, QIU Shi, LUO Shan-feng 2022, 20 (5):  483-487.  doi: 10.19438/j.cjoms.2022.05.012 Abstract ( 304 )   PDF (700KB) ( 115 )   PURPOSE: To explore the value of cone beam CT (CBCT) measuring the width and angle of the maxillary sinus to predict the stability of bone graft during alveolar crest top and maxillary sinus floor elevation. METHODS: Seventy- eight patients undergoing transalveolar crest maxillary sinus floor elevation and implantation at the same time were collected as research subjects. The width, angle of the maxillary sinus and the amount of bone resorption at the root end were examined by cone beam(CBCT) before and 6 months after operation. The factors affecting the stability of bone grafts during alveolar ridge top and maxillary sinus floor elevation were analyzed, and the value of maxillary sinus width and maxillary sinus angle in predicting the stability of bone graft stability during alveolar ridge top and maxillary sinus floor elevation was analyzed. SPSS 18.0 software package was used for data analysis. RESULTS: Bone resorption at the root end of the implant was (1.81±0.26) mm 6 months after operation. Among them, forty-nine patients had root end bone resorption ≤1.81 mm, and 29 patients had root end bone resorption >1.81 mm. Logistic multivariate regression analysis showed that the width and the angle of the maxillary sinus were independent factors affecting the stability of bone graft during alveolar crest top and maxillary sinus elevation (OR: 3.873, 4.518, 95%CI: 1.594~9.412, 1.859~10.979, P<0.05). ROC curve analysis showed that the AUC of maxillary sinus width, maxillary sinus angle and combination of the two to predict the stability of the bone graft during alveolar crest top and maxillary sinus elevation was 0.764, 0.742, 0.908, respectively. CONCLUSIONS: The width and angle of the maxillary sinus are indicators that affect the stability of bone graft during elevation of the alveolar crest and maxillary sinus floor. Combination of the two indicators is effective in predicting the stability of bone graft. References | Related Articles | Metrics

Clinical Reports

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Long-term performance of dental implants in vascularized iliac crest grafts for mandibular reconstruction in 14 consecutive patients GU Yu-wei, WANG Feng, HUANG Wei, ZHANG Zhi-yong, ZHANG Chen-ping, SUN Jian, WU Yi-qun 2022, 20 (5):  488-493.  doi: 10.19438/j.cjoms.2022.05.013 Abstract ( 257 )   PDF (1512KB) ( 144 )   PURPOSE: To evaluate the long-term performance of dental implants installed in vascularized iliac crest grafts for mandibular reconstruction by clinical and radiographic examinations. METHODS: From 1995 to 2005, 47 implants installed in vascularized iliac crest grafts for mandibular reconstruction in 14 patients were analyzed, including 30 implants immediately placed into vascularized iliac crest grafts in 10 patients and 17 implants placed later in 4 patients. The cumulative survival rate within 15 years of dental implants and prostheses was evaluated. Clinical assessments and radiographic examination were performed 5 years and 10 years after implant loading. Statistical analysis was performed using SPSS 26.0 software package. RESULTS: No early failures occurred during the healing period. Cumulative survival rates of implants for 10 years and 15 years were 90.44% and 86.67% and cumulative survival rate of prostheses for 15 years was 78.32%, respectively. The average marginal bone loss at 5 years was (2.08±0.27) mm, while that at 10 years was (4.22±0.48) mm (P<0.0001). Biological complications were peri-implantitis and soft tissue hyperplasia, and mechanical complication was abrasion of the prostheses mainly. CONCLUSIONS: The long-term performance of dental implants installed in vascularized iliac crest grafts for mandibular reconstruction is stable, which is an effective method for mandibular defect reconstruction, but the incidence of peri-implantitis is relatively higher. So, maintaining the stability of soft and hard tissues around the implant is a crucial guarantee for the long-term performance of implants. References | Related Articles | Metrics

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CT and MRI features of 29 patients with inflammatory myofibroblastic tumor in the head and neck WANG Can, ZHANG Chun-ye, TAO Xiao-feng, WANG Bo-cheng, ZHU Ling 2022, 20 (5):  494-499.  doi: 10.19438/j.cjoms.2022.05.014 Abstract ( 319 )   PDF (1266KB) ( 254 )   PURPOSE: To analyze the imaging features of inflammatory myofibroblastic tumor (IMT) in the head and neck through CT and MRI, and improve the correct diagnosis of the tumor before operation. METHODS: From January 2012 to December 2018, a total of 29 patients with IMT in the head and neck who were initially diagnosed and confirmed by postoperative pathology were retrospectively collected in Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine. Their preoperative CT and MRI findings were analyzed. RESULTS: Of the 29 patients with IMT in the head and neck, 67.0%(20/29) were misdiagnosed as malignant tumors before operation. The imaging findings of IMT in the head and neck were varied, 7 cases were identified as localized soft tissue mass, 12 cases with soft tissue mass and adjacent bone destruction (5 in the infratemporal fossa, 6 in the maxillary sinus, 1 in the wide maxillofacial region), and 10 cases with intraosseous mass (5 in the maxilla, 4 in the mandible, 1 in the temporal bone). 89.7%（26/29）were presented as uneven margins. 75.9%（22/29）showed bone destruction, 34.5%（10/29）with hyperostosis and remodeling. Eight cases had a peri-neural infiltration(6 cases occurred in the infratemporal fossa, with 4 cases suffered from invasion through foramen rotundum and foramen ovale, 2 cases invaded the optic canal, 2 cases occurred in the mandible and invaded the mandibular nerve canal). The IMT in the head and neck showed isodense or slightly hypodense, with no calcification on CT plain scan, and moderate/marked enhancement after contrast-enhanced scanning. MRI showed 9 cases with isointense or hypointense on T1 weighted images, 7 cases with hypointense on T2 weighted images, 9 cases with hyperintense on DWI. The range of ADC value of IMT (9 cases) was about (0.6-1.0)×10-3mm2/s. The TIC type of 7 cases was typeⅠ, and 2 cases with typeⅡ. There were no cervical lymph node metastasis and distant metastasis. CONCLUSIONS: IMT in the head and neck has certain imaging characteristics that are commonly found in malignant tumors. However, IMT in the head and neck can erode and remodel bone, with striped hypointense on T2 weighted image, mostly type I, few cervical lymph node metastasis and distant metastasis. CT, MRI and functional examination can reflect the tissue composition of the lesion to a certain extent, and provide an important basis for the correct preoperative diagnosis. References | Related Articles | Metrics

Dental Education

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Application of multidisciplinary teaching model in course teaching of temporomandibular joint diseases MA Zhi-gui, SHEN Pei, GE Jin, XIE Qian-yang, ZHAO Ning, DONG Min-jun, YNAG Chi 2022, 20 (5):  500-504.  doi: 10.19438/j.cjoms.2022.05.015 Abstract ( 278 )   PDF (735KB) ( 151 )   PURPOSE: To evaluate the teaching effects of multidisciplinary team (MDT) combined with case-based learning (CBL) in course learning of the treatment of temporomandibular joint (TMJ) diseases associated with dento-maxillofacial deformities. METHODS: A total of 24 postgraduates, residents for standardized training and students attending an advanced study from Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine were randomly divided into experimental group and control group, with 12 students in each group. MDT+CBL online and offline mixed teaching mode were applied in the experimental group while CBL online and offline teaching mode were used in the control group. After 3 months, the results of didactic examination and practice skill evaluation and questionnaire survey between the two groups were analyzed using SPSS 26.0 software package. RESULTS: Student's scores of theoretical knowledge and operational skills in the experimental group were significantly higher than those in the control group(P<0.05). Questionnaire results showed the scores of learning interest, communication skills, team work spirit, file management ability, medical record writing's quality, clinical thinking ability and literature review in the experimental group were all higher than those in the control group(P<0.05). CONCLUSIONS: The application of MDT combined with CBL online and offline mixed teaching mode can improve examination performance, stimulate students' study motivity, improve their professional quality and enhance their clinical comprehensive ability. It has positive effects on TMJ course teaching. References | Related Articles | Metrics

Review Articles

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Influencing factors of stability of inclined implant in patients with dentition defect HU Ning, JIANG Yin-hua 2022, 20 (5):  505-509.  doi: 10.19438/j.cjoms.2022.05.016 Abstract ( 353 )   PDF (534KB) ( 163 )   Clinically, patients with a few tooth loss have serious alveolar bone absorption at the missing tooth site. When axial implants are used, bone grafting or maxillary sinus floor lifting should be used to increase the bone mass, but there is still the risk of perforation of maxillary sinus mucosa or injury to mandibular nerve canal. Some clinicians use inclined implants to reduce the trauma of bone augmentation surgery and shorten the repair period. However, the stability of tilted implants has always been the focus of attention. This paper collected the relevant literatures in recent years to discuss the factors affecting the stability of tilted implants. References | Related Articles | Metrics

Case Reports

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A case of atypical mandibular schwannoma MENG Zhao-song, LI Xiao-nan, DONG Rui, ZHANG Jian 2022, 20 (5):  510-512.  doi: 10.19438/j.cjoms.2022.05.017 Abstract ( 276 )   PDF (932KB) ( 99 )   Schwannoma, which is a benign neoplasm originated from the neural sheath, is rare in jaw bones. Existed reports were cystic lesion without other features. This paper reported a case of schwannoma originated from the mandible, which featured as focal calcification. References | Related Articles | Metrics

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Intracranial dislocation of mandibular condyle: case report and literature review MA Yu-jie, YU Min-jie, SONG Sai-wen, ZHANG Xin-yue, CAI Yi-jing, CHEN Jie, YUAN Yong-xiang, JIANG Can-hua 2022, 20 (5):  513-516.  doi: 10.19438/j.cjoms.2022.05.018 Abstract ( 286 )   PDF (750KB) ( 179 )   The structurally weak mandibular condylar neck is more likely to break when subjected to external force. Mandibular condyle fractures can dissipate the traumatic energy, avoiding damage to the middle cranial fossa and other important anatomical structures of the brain, which can be regarded as a self-protection mechanism of the human body. A rare case of traumatic dislocation of the mandibular condyle into the middle cranial fossa was reported in this paper. The patient’s mandibular condyle without fracture was dislocated through the base of the middle cranial fossa into the cranium. The pathogenesis, clinical manifestations, diagnosis and treatment for intracranial dislocation of mandibular condyle were discussed with review of relative literatures. References | Related Articles | Metrics

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Giant basaloid squamous cell carcinoma of the left face: a case report ZHOU Yan-yan, LIU Li, JIN Wu-long 2022, 20 (5):  517-520.  doi: 10.19438/j.cjoms.2022.05.019 Abstract ( 352 )   PDF (1696KB) ( 194 )   Basaloid squamous cell carcinoma is a special subtype of squamous cell carcinoma. It is rare in clinic, especially in oral and maxillofacial skin. This paper reported a 57-year-old male patient with ulceration of the left face. Clinical examination found a large area of skin ulceration on the left face. The pathological diagnosis after biopsy was basaloid squamous cell carcinoma. After extensive resection of the tumor under general anesthesia, the defect was repaired with forearm free flap, followed by radiotherapy. Twelve months after operation, the patient was alive with no evidence of disease. Based on review of relevant literatures, the clinical characteristics, risk factors, tissue origin, diagnosis, differential diagnosis, treatment and prognosis of basaloid squamous cell carcinoma were analyzed. References | Related Articles | Metrics