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20 July 2023, Volume 21 Issue 4 Previous Issue    Next Issue

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Expert Consensus

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Expert consensus on diagnosis and clinical management of medication-related osteonecrosis of the jaw HE Yue, CHEN Heng, AN Jin-gang, GUO Yu-xing, PAN Jian, TIAN Lei, LIU Bing, HOU Jin-song, LI Jin-song, JIANG Can-hua, LI Meng-yu, TIAN Zhen, XU Jie, ZHU Ling, SUN Chang-fu, ZHI Ke-qian, QU Qing, ZONG Chun-lin, SUN Jing-jing, ZHANG Zhi-yuan 2023, 21 (4):  313-325.  doi: 10.19438/j.cjoms.2023.04.001 Abstract ( 1169 )   PDF (2051KB) ( 1406 )   Medication-related osteonecrosis of the jaw(MRONJ) is a complication caused by the application of anti-resorptive medications, angiogenesis inhibitors, hormones and other medications for the treatment of some systemic diseases. The clinical symptoms include swelling, pain, masticatory disorders, persistent fistula, bone exposure and even pathological fracture, which seriously affect the patients' quality of life. Domestically, there is a lack of consensus or guidelines on classification, staging and treatment of MRONJ, and different institutions make diagnosis and treatment plans empirically. In order to unify and standardize the diagnosis and treatment of MRONJ and improve the prognosis, an expert panel of MRONJ research from 12 famous domestic medical colleges and affiliated hospitals convened a meeting to discuss the diagnosis and treatment opinions of MRONJ. Meanwhile, consensus recommendations were also revised with a comprehensive literature review of the previous treatment experiences and research findings. Finally, this expert consensus was finished for clinical references. References | Related Articles | Metrics

Original Articles

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Protein profiling analysis of oral squamous cancer derived extracellular vesicle subgroups WU Ruo-yi, WANG Xiao-ning, ZHAI Pei-song, ZHANG Jian-jun, CHEN Wan-tao 2023, 21 (4):  326-331.  doi: 10.19438/j.cjoms.2023.04.002 Abstract ( 245 )   PDF (1063KB) ( 168 )   PURPOSE: To reveal the commonality and heterogeneity in protein contents of extracellular vesicles (EVs) subgroups obtained by different immunomarkers, and provide data support for researchers to select appropriate isolation protocols. METHODS: In this study, oral cancer cells CAL27, pancreatic cancer cells PANC-1 and gastric cancer cells AGS were used, and EVs derived from them were isolated by 4 EVs markers CD9, CD63, CD81 and EpCAM. Then the proteins from these 4 different EVs subgroups were detected by mass spectrometry. The commonality and heterogeneity between EVs subgroups were evaluated by funrich3.1.3 software. SPSS 19.0 software package was used for statistical analysis. RESULTS: Under the same culture conditions, AGS cells produced the highest number of EVs, followed by CAL27 cells and the least by PANC-1 cells. Among the 4 different EVs isolation methods, the EpCAM marker-based isolation method was the most efficacious. The results of principal component analysis showed that the subgroups of EVs involved in this study were heterogeneous at the level of cell origin as well as at the level of isolation markers. The results of the cellular component analysis of the protein profile showed that 86.11% of the proteins enriched by CD63+ EVs derived from CAL27 were related to exosomes, which was significantly higher than the percentage of the CD9+, CD81+ and EpCAM+ EVs subgroups(70.92%, 70.90% and 63.68%); while 37.96% of the enriched proteins in the CD63+ EVs subgroup were related with cell membrane, which was lower than the percentage of CD9+, CD81+, and EpCAM+ EVs subgroups (53.20%, 61.19% and 49.53%), indicating that EVs subgroups isolated by different immunomarkers had different origins. CONCLUSIONS: The subgroups of EVs involved in this study are heterogeneous at the cellular origin level and at the immunomarker level. Among them, CD63+ EVs may originate more from the endosomal pathway, while CD9+, CD81+ and EpCAM+ EVs originate more from the plasma membrane outgrowth pathway. The EVs subgroups obtained based on different isolation markers were differential in terms of cell biological functions. References | Related Articles | Metrics

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Single-cell transcription atlas for mandibular condyle cartilage and subchondral bone marrow in rat temporomandibular joint osteoarthritis YU Ye-ke, DING Ruo-yi, SUN Jia-li, ZHANG Zhi-yuan, HE Dong-mei 2023, 21 (4):  332-339.  doi: 10.19438/j.cjoms.2023.04.003 Abstract ( 351 )   PDF (2829KB) ( 256 )   PURPOSE: To establish the single-cell transcriptome atlas for rat condyle osteochondral tissue and bone marrow both in normal and temporomandibular joint osteoarthritis (TMJOA) condition. METHODS: Rat unilateral anterior crossbite(UAC) model was built to induce TMJOA. Osteochondral cells and bone marrow immune cells were extracted for single-cell RNA sequencing. Quality control, dimension reducing, clustering and marker gene detection were used to depict cell subclusters. Differential gene expression analysis and functional enrichment were utilized to demonstrate cell cluster functions and their changes under UAC. Pseudo-time analysis was applied for cell development trajectory, while cell communication prediction was used to show alternations in the interaction among cell clusters. RESULTS: There were 9 cell clusters in rat condyle, containing osteochondral cells and bone marrow immune cells. Under UAC, the number of osteochondrocytes decreased whereas immune cells accumulated. Condyle cartilage and bone tissue contained 6 functional groups of cells. Among them, D and F group maintained progenitor characteristics and possessed the ability to develop into other groups. In UAC condition, osteochondrocytes witnessed impaired extracellular matrix organization, activated senescent or inflammatory pathways, and diminished cell-cell interaction. Meanwhile, in the bone marrow, neutrophils showed enhanced chemotaxis and degranulation, mononuclear-phagocytes displayed increased phagosomes, activated B cells were also recruited. CONCLUSIONS: There are progenitor cells in condyle cartilage and bone tissue, whose function impaired under UAC. At the same time, immune cells in the bone marrow are activated. Targeted modulation of osteochondral progenitors and immune cells could contribute in alleviation the condyle tissue damage in TMJOA. References | Related Articles | Metrics

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Experimental study on embolization and sclerotherapy of cervicofacial venous malformations with fibrin glue combined with pingyangmycin YAN Zhi-wei, SHEN Yan-ling, GUO Jun, LIU Yuan, YANG Xia, LI Huan, FENG Yao, SUN Mo-yi, YANG Yao-wu 2023, 21 (4):  340-344.  doi: 10.19438/j.cjoms.2023.04.004 Abstract ( 180 )   PDF (1957KB) ( 76 )   PURPOSE: To evaluate the efficacy of embolosclerotherapy using fibrin glue(FG) combined with pingyangmycin (PYM) in animal model of cervicofacial venous malformations(VMs). METHODS: A total of 15 sheep were selected to make animal models of VMs. The VMs animal models were divided into PYM group, FG group, and FG/PYM group , which were injected with PYM, FG and FG/PYM respectively. Four weeks after injection, the effect of embolization and sclerotherapy on vascular fibrosis were evaluated through Doppler ultrasound, gross and histological observations. RESULTS: Four weeks after PYM injection, the venous wall was slightly thickened, the pore size was slightly reduced, some vascular lumens were unobstructed, and some had thrombosis. Doppler ultrasound showed clear venous lumen and blood flow. Histological observation showed that the morphology of most venous endothelial cells and the structure of the vascular wall were basically normal. The continuity of some venous intima was incomplete, and the local intima disappeared in some vascular walls and the fibrous tissue hyperplasia could be seen. Four weeks after FG injection, Doppler ultrasound showed that venous blood flow disappeared or decreased significantly. Gross observation showed thickening of the venous wall and narrowing of the lumen, and yellow or dark red jelly-like emboli with certain toughness were observed in the lumen. Histological observation showed that the lumen had an amorphous substance, mature or immature fibrous tissue grew into the amorphous mass, and the structure of the vessel wall was unclear. Four weeks after FG/PYM injection, Doppler ultrasonography showed loss of venous blood flow. Gross observation showed obvious thickening of the venous wall, yellow or dark red emboli were seen in some venous lumens, and some lumens were basically blocked. Histological observation showed that some lumens contained an amorphous substance, a large number of mature or immature fibrous tissues were seen in the vascular region, and the vessel wall structure was disappeared. Histological examination showed that some lumens were amorphous, a large number of mature or immature fibrous tissues were seen in the vascular region, and the vessel wall structure disappeared. CONCLUSIONS: Embolization and sclerotherapy with FG combined with PYM has shown good effect in promoting the destruction of vascular endothelial cells and vascular fibrosis. The results reveal the potential advantages and application prospects of this technique in the treatment cervicofacial VMs. References | Related Articles | Metrics

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The mechanism of lipopolysaccharide upregulating trigeminal ganglionic sodium channel 1.7 expression in rats YAN Ting-ting, ZHANG Jing, ZHUANG Li-kun, WANG Li-li, ZHANG Peng, YUAN Rong-tao 2023, 21 (4):  345-351.  doi: 10.19438/j.cjoms.2023.04.005 Abstract ( 196 )   PDF (1118KB) ( 95 )   PURPOSE: To investigate whether and how lipopolysaccharide(LPS) upregulates the expression of sodium channel 1.7 (Nav1.7) in trigeminal ganglion (TG), and then participate in temporomandibular joint (TMJ) inflammatory pain in rats. METHODS: Through microinjection of LPS into the TG in adult male Sprague-Dawley (SD) rats, rats' head withdrawal threshold was observed and the expression of Nav1.7 in TG was detected. After culturing rats TG explants in vitro, the rats TG explants were treated with LPS with or without inhibitors, including fluorocitrate(FC) for satellite glial cell (SGC) activation and pyrrolidinedithiocarbamate (PDTC) for NF-κB, and then the expression changes of Nav1.7, p-p65 and GFAP in TG was detected using real-time PCR and Western blot assays. SPSS 22.0 software package was used for data analysis. RESULTS: Nav1.7 expression was significantly upregulated in the TG and the head withdrawal threshold was reduced after microinjection of LPS into the TG for 24 h. LPS-induced upregulation of Nav1.7 expression in the TG was blocked by SGC activation inhibitor FC. LPS-induced upregulation of p-p65, GFAP and Nav1.7 expressions in the TG were blocked by NF-κB inhibitor PDTC. CONCLUSIONS: LPS upregulates the expression of Nav1.7 through NF-κB signaling pathway (p-p65) activating satellite glial cell (SGC) of trigeminal ganglion, and then participates in TMJ inflammatory pain in rats. References | Related Articles | Metrics

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The role of MAP7D3 in head and neck squamous cell carcinoma LIU Yu, CHEN Yu-ling, LIN Yun-tao, YANG Hong-yu 2023, 21 (4):  352-359.  doi: 10.19438/j.cjoms.2023.04.006 Abstract ( 178 )   PDF (2509KB) ( 77 )   PURPOSE: The aim of this study is to figure out MAP7D3 expression level, diagnostic and prognostic value in head and neck squamous cell carcinoma (HNSCC) by bioinformatics technology and to initially explore the effect of the expression change of MAP7D3 on the biological behavior of HNSCC cell lines. METHODS: Expression analysis, clinicopathological characteristics correlation analysis, survival analysis, Cox regression analysis, ROC curve analysis and GSEA analysis were performed in HNSCC by bioinformatics.The expression of MAP7D3 were detected by qRT-PCR and immunohistochemistry staining in HNSCC cell lines(WSU-HN6, CAL27) and HNSCC tissues. Downregulation of MAP7D3 by siRNA was identified by qRT-PCR. CCK8 assay, flow apoptosis assay, wound healing assay and transwell assay ware performed to detect the effect of knocking down MAP7D3 on the biological behaviors of HNSCC cell lines WSU-HN6 and CAL27. RESULTS: MAP7D3 was highly expressed in HNSCC at both RNA and protein level by bioinformatic analysis, qRT-PCR and immunohistochemical staining. Clinical correlation analysis revealed that the expression level of MAP7D3 was correlated with pathological grade. Overall survival, disease specific survival and progress free interval were shorter in patients with high MAP7D3 expression compared with patients with low MAP7D3 expression. Univariate and multivariate Cox regression analysis showed that MAP7D3 expression could be an independent risk factor for prognosis of HNSCC patients. ROC curves showed the diagnostic value of MAP7D3 in differentiating HNSCC tissue from normal tissue. GSEA enrichment analysis showed that MAP7D3 high expression group was enriched in various signaling pathways such as focal adhesion and ECM-receptor interactions. CCK-8 assay, flow apoptosis assay, wound healing assay and transwell assay showed that knockdown of MAP7D3 can inhibit the proliferation, migration, invasion and increase apoptosis of HNSCC cell lines WSU-HN6 and CAL27. CONCLUSIONS: MAP7D3 is highly expressed in HNSCC and can be used as a potential diagnostic and prognostic biomarker for HNSCC. Downregulation of MAP7D3 can inhibit the proliferation, migration and invasion of HNSCC cell and increase cell apoptosis. References | Related Articles | Metrics

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Retrospective analysis of 190 cases of oral and maxillofacial space infection complicated with hyperglycemia YANG Zuo-yi, YE Lei, ZHENG Ling-yan, CHEN Chang-yu, FU Jia-yao 2023, 21 (4):  360-365.  doi: 10.19438/j.cjoms.2023.04.007 Abstract ( 274 )   PDF (684KB) ( 159 )   PURPOSE: To analyze the difference between oral and maxillofacial space infection(OMSI) patients with diabetes mellitus, stress hyperglycemia and normal blood glucose in general data, clinical manifestations, laboratory test, and dominant bacterial flora of infection. METHODS: A retrospective study was conducted in 190 patients diagnosed with oral and maxillofacial infection and treated at the Department of Oral Surgery, Shanghai Ninth People's Hospital from August 2020 to June 2022. Statistical analysis of general data, clinical manifestations, laboratory test, and dominant bacterial flora of infection between the three groups was performed with SPSS 25.0 software package. RESULTS: Between diabetic group and stress hyperglycemia group, absolute number of lymphocytes, sodium and chlorine differed significantly; between diabetic group and normal blood glucose group, age, neutrophil absolute number, neutrophil percentage, lymphocyte percentage, C-reactive protein, IL-6, IL-8, tumor necrosis factor-α, procalcitonin, urea, serum uric acid, fibrinogen, sodium, chlorine and total carbon dioxide differed significantly; between stress hyperglycemia group and normal glycemia group,the percentage of neutrophil, percentage of lymphocyte, absolute number of lymphocyte, C-reactive protein, IL-8, tumor necrosis factor-α, and urea differed significantly. CONCLUSIONS: The clinical features and laboratory results of OMSI patients with diabetes, stress hyperglycemia and normal blood glucose are significantly different, suggesting that the three groups of patients should be distinguished in clinical diagnosis and treatment, and more targeted treatment should be provided. References | Related Articles | Metrics

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Application of experience-based co-design in home enteral nutrition for patients with head and neck cancer after operation CHEN Yue, MAO Yan 2023, 21 (4):  366-371.  doi: 10.19438/j.cjoms.2023.04.008 Abstract ( 189 )   PDF (768KB) ( 95 )   PURPOSE: To explore the effect of experience-based co-design (EBCD) in home enteral nutrition (HEN) for patients with head and neck cancer (HNC) after operation. METHODS: A total of 41 patients with HNC collected in our hospital from May to September 2021 were selected as the control group, and provided with routine enteral nutrition health education and discharge instruction. Meanwhile, another 41 patients with HNC collected from October 2021 to March 2022 were included in the experimental group, and were given EBCD-based HEN as the basis of the scheme in the control group. The nutritional status, self-management efficacy and quality of life of patients in the two groups were compared before discharge as well as 1 month and 3 months after discharge. SPSS 20.0 software package was used for data analysis. RESULTS: Three months after discharge, the PG-SGA score of the patients in the experimental group was better than that of the patients in the control group, and the levels of hemoglobin, serum albumin and total serum protein were significantly higher in the experimental group than those of the control group (P<0.05). Furthermore, the self-management efficacy and quality of life scores of the patients in the experimental group were better than those in the control group at 1 month and 3 months after discharge. There were significant differences in the intervention effect, time effect and interaction effect between the two groups(P<0.05). CONCLUSIONS: HEN based on EBCD contributes to the improvement of the service quality of HEN according to the experience of HEN patients, which effectively improves the nutritional status, quality of life and self-management efficiency of these patients. References | Related Articles | Metrics

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The relationship between nasalance and velopharyngeal closure status after cleft palate surgery GAO Tao, MA Lian, LUO Yi, SUN Yong-gang 2023, 21 (4):  372-376.  doi: 10.19438/j.cjoms.2023.04.009 Abstract ( 198 )   PDF (973KB) ( 129 )   PURPOSE: To investigate the relationship between nasalization rate and palatopharyngeal closure in patients with secondary structural speech disorder after cleft palate surgery. METHODS: A total of 407 speech samples of patients with postoperative cleft palate speech disorders without speech substitution from the Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University were included. The nasal sound meter and nasopharyngeal fiber endoscope were used to record the nasal phonation rate and the score of nasopharyngeal fiber endoscopic visual analog scale (VAS) of the speech samples. The nasal phonation rate values and VAS values were compared by Pearson analysis. SPSS 13.0 software package was used for data analysis. RESULTS: There was negative correlation between nasal phonetic rate and VAS value of 407 speech samples. Velopharyngeal insufficiency was worse, and nasal phonetic rate was higher. There was a significant negative correlation between nasal phonetic rate and VAS value of 296 non-nasal speech samples. According to VAS values of 296 non-nasal speech samples, it suggested if nasalance scores was below 30%, complete or marginal velopharyngeal closure was considered. If nasalance scores is between 30% and 50%, mild velopharyngeal impairment should be considered. If nasalance scores was over 50%, medium or severe velopharyngeal impairment should be considered. CONCLUSIONS: The study showed nasometer can give a clue preliminarily of the velopharyngeal closure status in patients with hypernasality and nasal air emission objectively. References | Related Articles | Metrics

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Effect of extranodal extension on TNM staging and survival in patients with oral squamous cell carcinoma LI Gui-zhong, LI Jie-ying, ZHOU Kai, MENG Yu-xiang, WANG Ke-xin, GE Sheng-you, SONG Kai, FENG Yuan-yong, TAO Yue-qin, ZHAN Xiao-hong, SHANG Wei 2023, 21 (4):  377-383.  doi: 10.19438/j.cjoms.2023.04.010 Abstract ( 315 )   PDF (1371KB) ( 200 )   PURPOSE: By analyzing the influence of extranodal extension (ENE) on TNM staging manual and survival after included into the staging, to learn about the significance of ENE on clinical decision-making and prognosis of oral cancer. METHODS: A retrospective cohort study of 485 patients with primary oral squamous cell carcinoma(OSCC) from January 2014 to June 2017 was performed in the Affiliated Hospital of Qingdao University. The AJCC 7th and 8th edition staging systems was applied to the patients. Overall survival and disease-specific survival were analyzed by Kaplan-Meier analysis and Log-rank test with SPSS 26.0 software package. Concordance index and Akaike information criterion(AIC) was used to evaluate the system’s prognostic capacity. RESULTS: A total of 485 patients with OSCC were followed up. The pathological N stage of 69 (14.43%) patients (including 16 pN2a and 53 pN3b) was changed by extranodal extension. The pathological TNM stage of 67(13.81%) patients (including 14 ⅣA and 53 ⅣB) was also changed because of ENE. Overall survival and disease-specific survival model analysis of N stage, TNM stage and ENE showed that patients with positive ENE (OS:27.1%, DSS:31.2%) had a lower survival rate than those with negative ENE(OS:72.2%, DSS:78.0%). AIC of AJCC 8th edition staging systems was lower than 7th edition and there was little difference between them in terms of concordance index. CONCLUSIONS: Extranodal extension changed TNM staging of OSCC patients. The number of advanced patients increased significantly and the survival prognosis became worse. ENE can objectively refect the status of the patients. It has more guiding significance for decision-making and prognosis evaluation of oral cancer patients. References | Related Articles | Metrics

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The incidence and risk factors of acute kidney injury after surgery for oromaxillofacial head and neck tumor LI Ping, LUO Tao, HUANG Can, ZHOU Chi, SUN Yu 2023, 21 (4):  384-389.  doi: 10.19438/j.cjoms.2023.04.011 Abstract ( 195 )   PDF (680KB) ( 110 )   PURPOSE: To determine the incidence and risk factors of acute kidney injury (AKI) in patients undergoing surgery for oromaxillofacial head and neck tumors. METHODS: Patients undergoing surgery for oromaxillofacial head and neck cancer from January 2014 to December 2021 at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine were collected and retrospectively analyzed. AKI was defined an absolute increase in plasma creatinine of 26.5 μmol/L within 48 h or a 1.5 times increase in creatinine within 7 days according to the Kidney Disease Improving Global Outcomes(KDIGO) criteria. Two groups were divided according to whether AKI occurred after surgery: AKI group and non-AKI group. The incidence of postoperative AKI was calculated, and the rates of postoperative mechanical ventilation, mortality, ICU stay, length of hospital stay and hospital costs were compared between the two groups. Logistic regression analysis was performed to identify independent risk factors for AKI with SPSS 26.0 software package. RESULTS: A total of 6 830 patients (mean age 59.3 years, 4 238 men and 2 592 women) were included. Postoperative AKI was observed in 134(2.0%) patients, with stage 1, 2 and 3 AKI in 129, 4 and 1, respectively. Multivariate logistic analysis revealed that female (OR=2.166, 95%CI: 1.440-3.259), non-steroidal anti-inflammatory drugs(NSAIDs) (OR=2.305, 95%CI: 1.088-4.883), anemia(OR=1.688, 95%CI: 1.132-2.517), albuminuria(OR=2.080, 95%CI: 1.242-3.482) and prolonged anesthesia (OR=0.346, 95%CI: 0.196-0.612) were independently associated with the development of AKI. Patients in the AKI group had a higher mortality rate(1.0%) during hospitalization, but AKI did not impact clinical outcomes. CONCLUSIONS: Postoperative AKI occurred in 2.0% of patients after oromaxillofacial head and neck tumor surgery. Female, NSAIDs, anemia, albuminuria and long-term anesthesia were independent risk factors for postoperative AKI. References | Related Articles | Metrics

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Accuracy of MRI to measure and evaluate clinical staging of oral squamous cell carcinoma SI Cheng-yun, LIU Meng-qiu, WENG Hai-yan, ZHANG Li-yu, AN Xing-fei, ZHOU Yu 2023, 21 (4):  390-396.  doi: 10.19438/j.cjoms.2023.04.012 Abstract ( 296 )   PDF (1445KB) ( 127 )   PURPOSE: To investigate the accuracy of magnetic resonance imaging (MRI) for measuring and assessing the clinical staging of oral squamous cell carcinoma (OSCC). METHODS: A total of 71 patients with OSCC in The First Affiliated Hospital of University of Science and Technology of China from February 2020 to September 2022 were enrolled. The MRI measurements of maximum tumor diameter(MTD), depth of invasion(DOI), and maximum cut sections were recorded, pathological sections were made on the sections, the pathological MTD and DOI were measured and statistically analyzed, and the cervical lymph node status assessed by MRI was compared with the postoperative pathological lymph node status to analyze the accuracy of preoperative MRI measurements and clinical staging. SPSS 26.0 software package was used for data analysis. RESULTS: The mean DOI measured on the MRI was 2.54 mm(95%CI: 3.56-1.53, P<0.05), higher for Gd-T1WI sequence, with correlation coefficient r=0.984; the mean DOI measured on T2WI sequence was 3.09 mm(95%CI: 4.88-1.29, P<0.05) higher, with correlation coefficient r=0.953. Bland-Altman dot plots showed that the measurements of Gd-T1WI sequence were more consistent with pathological DOI values. At the same time, the clinical measurements of MTD were 0.85 cm (95%CI: 0.78-0.91, P<0.05), higher than the histologic findings, with correlation coefficient r of 0.958; the MRI measurements of MTD were 0.21 cm(95%CI: 0.10-0.32, P<0.05), higher than the histologic findings, with correlation coefficient r of 0.878. The MTD measured by MRI was significantly lower than that measured by clinical visualization. The preoperative assessment of cervical lymph node status by MRI was true-positive in 69.6% and true-negative in 89.6% of patients. CONCLUSIONS: MRI has a high accuracy in measuring clinical stage in patients with OSCC and can be used as a reliable reference method for assessing clinical stage. References | Related Articles | Metrics

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Evaluation of the application of double wire anchor nails in temporomandibular joint disc anchorage WUERGULI Alifu, REYILAI Abudukeremu, LIU Jiang-long, MAIMAITITUXUN Tuerdi 2023, 21 (4):  397-402.  doi: 10.19438/j.cjoms.2023.04.013 Abstract ( 347 )   PDF (1789KB) ( 403 )   PURPOSE: To evaluate the clinical efficacy of double wire anchorage in the treatment of temporomandibular joint disc anterior displacement. METHODS: Thirty patients with anterior disc displacement without reduction(ADDWoR) diagnosed in First Affiliated Hospital of Xinjiang Medical University from June 2021 to February 2022 were included to fix the discs with double wire anchors. The maximal open mouth, visual analogue scale (VAS) scores of the patients before and at different time periods were analyzed, the patients' self-satisfaction was recorded, and the length of MRI discs and condylar height before and after operation were measured. SPSS 25.0 software was used to analyze the data and evaluate the surgical results. RESULTS: The mean age was 24.43±8.87 years old, the mean mouth opening before operation was (29.17±5.38) mm (19-42 mm), the mean maximum mouth opening after operation was (39.17±2.57) mm (35-45 mm), and 93.3% of the patients after operation had the maximum mouth opening >35 mm; the mean VAS before operation was 58.33±21.19 (10-90), the mean VAS 6 months after operation was 11.67±6.99(0-20), the mouth opening and the value of VAS 6 months after operation had significant difference compared with prior to operation(P<0.05). The disc length was (9.77±0.63), (11.96±0.68) and (12.72±0.55) mm preoperatively, immediately postoperatively and 6 months after surgery. The condyle height increased by (1.08±0.61) mm 6 months after surgery compared with immediately postoperatively (P<0.05). CONCLUSIONS: Double wire anchorage in the reduction and anchorage of TMJ disc can improve the mouth opening, relieve pain, increase the length of TMJ disc and increase the height of condyle. References | Related Articles | Metrics

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Effect of alveolar fossa preservation with different implant materials on alveolar ridge resorption in patients undergoing posterior tooth extraction ZHU Min-yan, WANG Hai-yan, YUAN Yin-yin 2023, 21 (4):  403-406.  doi: 10.19438/j.cjoms.2023.04.014 Abstract ( 255 )   PDF (497KB) ( 135 )   PURPOSE: To investigate the effect of alveolar preservation with different implant materials on alveolar ridge absorption in patients with posterior tooth extraction. METHODS: Eighty-six patients with tooth restoration after extraction admitted to Zhejiang Greentown Cardiovascular Hospital from March 2016 to April 2020 were selected. The patients were divided into experimental group and control group according to the random number, 43 cases in each group. After tooth extraction, patients in the experimental group implanted platelet-rich fibrin(PRF) into the alveolar fossa, while patients in the control group implanted collagen plugs into the alveolar fossa after tooth extraction. The time of wound healing, the height of alveolar soft tissue and the width of alveolar ridge were observed immediately and 6 months after surgery. SPSS 23.0 software package was used for data analysis. RESULTS: The postoperative wound healing time was (10.52±3.14) d in the experimental group, which was significantly shorter than (17.68±5.35) d in the control group(P<0.05). The alveolar soft tissue height of the experimental group was significantly lower than that of the control group 6 months after operation(P<0.05), but there was no significant difference between the mesial papilla and distal papilla (P>0.05). The experimental group was significantly higher than the control group in alveolar ridge widths at 20% and 70% of the root length 6 months postoperatively (P<0.05), but there was no significant difference between the two groups at 50% of the root length (P>0.05). CONCLUSIONS: Compared with collagen plug, the application of PRF in the preservation of extraction site can promote wound healing time and reduce absorption of alveolar ridge. It is an ideal filling and covering material for the preservation of extraction site at present. References | Related Articles | Metrics

Evidence-Based Medicine

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Meta analysis of risk factors for postoperative delirium in patients with head and neck tumours XIANG Fu-ping, HOU Li-li, YANG Ling, WANG Yu, LIANG Jia-qing 2023, 21 (4):  407-412.  doi: 10.19438/j.cjoms.2023.04.015 Abstract ( 164 )   PDF (785KB) ( 99 )   PURPOSE: To identify the risk factors of postoperative delirium in patients with head and neck tumours and provide evidence for early prevention of clinical patients. METHODS: A systematic search of PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang, CBM and VIP was conducted. Cohort studies and case-control studies on risk factors for postoperative delirium in patients with head and neck tumours were collected. The retrieval period was from the database construction to May 2022. RevMan 5.0 software was used for meta analysis. RESULTS: A total of 15 articles were included, with a sample size of 5801 cases, including 13 risk factors: age(WMD=7.24), gender(OR=1.99), with hypertention(OR=2.94), with diabetes(OR=1.49), preoperative mental disease(OR=3.50), smoking history (OR=1.79), ASA grade≥Ⅲ(OR=2.43), time of anesthesia (WMD=32.87), tracheotomy(OR=2.25), neck dissection (OR=2.47), intraoperative blood loss(WMD=124.77), postoperative sleep disorder(OR=5.28) and postoperative electrolyte disorder (OR=2.45). CONCLUSIONS: Medical staff should focus on the assessment and management of risk populations, reduce postoperative delirium in patients with head and neck tumours as much as possible, and improve the clinical prognosis of patients. References | Related Articles | Metrics

Review Articles

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Research progress of β-catenin in tooth development SUI Xin, DU Zhong 2023, 21 (4):  413-417.  doi: 10.19438/j.cjoms.2023.04.016 Abstract ( 190 )   PDF (527KB) ( 114 )   β-catenin is the central hub in the canonical Wnt/β-catenin signaling pathway, which plays an important role in the regulation of odontogenesis and tooth development. In this paper, we reviewed the recent research progress in terms of the expression pattern of β-catenin during tooth development, the molecular mechanism of β-catenin in tooth development process which includes odontogenesis, crown development and root formation. It may provide a reference for elucidation of tooth development mechanism, exploration of potential therapeutic targets of tooth development related diseases, and precise regulation of tooth regeneration. References | Related Articles | Metrics

Case Reports

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Multifocal adenomatous oncocytic hyperplasia in bilateral parotid gland: a case report and review of literatures WU Ya-nan, YU Ning, FAN Zhi-wei, WANG Wen-long, MA Xiang-rui, WANG Jing 2023, 21 (4):  418-420.  doi: 10.19438/j.cjoms.2023.04.017 Abstract ( 190 )   PDF (876KB) ( 96 )   Multifocal adenomatous oncocytic hyperplasia is a rare benign salivary gland lesion. A case of multifocal adenomatoid oncocytic hyperplasia in bilateral parotid gland was reported,and the clinical pathologic features,diagnosis and treatment were discussed based on the literature,in order to provide reference for clinical diagnosis and treatment. References | Related Articles | Metrics

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Diagnosis and treatment of oral soft tissue infection caused by pericoronitis after bone marrow transplantation: a case report PANG Chao-yuan, TIAN Wen-yan 2023, 21 (4):  421-424.  doi: 10.19438/j.cjoms.2023.04.018 Abstract ( 238 )   PDF (1159KB) ( 109 )   Hematopoietic stem cell transplantation(HSCT) is one of the important methods for the treatment of severe aplastic anemia(SAA). Some oral complications will occur during bone marrow transplantation period such as oral ulcer and infections. Prevention and treatment of these oral complications reasonably is the key to the success of bone marrow transplantation. In this paper, we reported the clinical treatment of a patient with oral soft tissue infection caused by pericoronitis after bone marrow transplantation, in order to investigate oral health management of bone marrow transplantation patients and provide some reference to improve the success rate of bone marrow transplantation. References | Related Articles | Metrics