Objective To review the patients who underwent accurate maxillary and mandibular reconstruction with vascularized osteomyocutaneous flap using virtual surgery and evaluate the postoperative results. Methods From June of 2009 to December of 2014, ninety-four patients were treated in our department. In virtual surgical planning, maxillectomy and mandibulectomy were simulated and donor site bone was superimposed mirror image of normal maxilla and mandible to complete accurate maxillary and mandibular reconstruction. Maxillectomy, mandibulectomy and bone reconstruction were performed using stereomodels and guided templates to replicate the virtual planning. Actual reconstruction result was compared with that of virtual surgery. The patients were asked to assess their satisfaction with facial appearance at 1 year postoperatively. Results Good bony unions and occlusion were observed in 94 patients. The actual results were basically in accordance with that of virtual surgery. The actual deviation between postoperative CT and preoperative virtual surgical planning was no more than 1 mm matched by computer software. All patients reported their facial appearance were excellent or good at 1 year postoperatively. Conclusion The ideal contour of neomaxilla and neomandible and good function with dental rehabilitation can be gained after accurate maxillary and mandibular reconstruction with vascularized osteomyocutaneous flap using virtual surgery.
Cracked tooth is a common type of tooth fracture with diverse symptoms, different treatment principles and unpredictable prognosis. The available remedies for immediate, intermediate and definitive managements include occlusal adjustment, orthodontic band, bonded composite resin, onlay, full crown and so on. For teeth with localized crack and vital pulp, bonded composite resin and onlay with cuspal coverage are also protective remedies besides traditional full-crown restoration. Once pulpal infection occurs, root canal therapy and full-crown restoration is indicated. Clinical determination should be made with comprehensive consideration of the location and depth of the crack, risk of extension and pulpal condition. This review will focus on the traits and prognosis of various therapy options, so as to provide evidence-based treatment planning of cracked tooth.
Derived from the neural crest, dental stem cells (DSCs) are a population of cells with the characteristics of mesenchymal stem-ness, which under certain appropriate conditions can differentiate into multiple cells such as osteocytes, chondrocytes, hepatocyte and neuronal-like cells. DSCs are consist of odontogenic stem cells mainly include dental pulp stem cells, periodontal ligament stem cells, stem cells from deciduous teeth, stem cells from apical papilla, as well as dental follicle progenitor cells. DSCs have been widely used in the field of regenerative medicine research and preclinical research, including nervous system diseases, oral diseases, immune diseases, heart and lung diseases, etc. This review will focus on the storage of DSCs and current translational and clinical studies regarding DSCs in tissue regeneration.
Objective To investigate the effects of different root canal filling stop on quality of root canal filling and apical sealing in root canals obturated with GuttaFlow. Methods 60 teeth were randomly divided into three groups, using different root canal filling stops to shape the root canals with MTwo (25/06) file. All root canals were obturated with Gutta Flow, and the overfilling of the root canals were recorded and evaluated by X-ray. And the apical microleakage of teeth was evaluated by transparent teeth technique. Results The roots were prepared with MTwo (25/06) as master apical file, the overfilling rate of the root canals in root canal filling stop was higher as the distance from the apex was shorter, but there was no significant difference. The under-filling rate of the root canals in root canal filling stop was higher as the distance from the apex was longer. And the under-filled root canals in root canal filling stop 0.5 mm from the apex showed a statistically significant difference with 2 mm. The mean dyeing penetration length in 0.5 mm and 1 mm group was significantly shorter than 2 mm group. Conclusion A suitable root canal filling stop could improve the quality of root canal filling in root canals obturated with GuttaFlow.
Objective To investigate the expression of targeting protein for xenopus kinesin-like protein2 (TPX2) in tongue squamous cell carcinoma (TSCC) tissues and explore its effect on cell proliferation and apoptosis. Methods 30 cases of TSCC tissues, paired normal tissues were collected in Dongguan People's Hospital during 2013-2016. The mRNA and protein expression level of TPX2 was determined by qRT-PCR and western blot, respectively and analyzed The correlation of TPX2 expression level and clinic opathological parameters. Cal27 cell was transfected with siRNAs to knockdown the expression of TPX2, then cell proliferation, cell apoptosis and related proteins (cleaved caspase 3 and caspase 3) were detected by MTT assay, flow cytometry and western blot. Results TPX2 was highly expressed in (t=3.254, P=0.002 9) tumor tissues at mRNA level compared to adjacent normal parts. In protein level, TPX2 was highly expressed (66.7%) in tumor tissues, TPX2 expression level of 20 case was higher than the corresponding tissue adjacent to carcinoma (20/30, t=2.862, P=2.862), and high expression of TPX2 was related to T staging, lymph node metastasis of tongue cancer. Knockdown TPX2 effectively reduced cell proliferation, increased apoptosis rate (F=342.9, P < 0.000 1) and upregulated the expression of apoptosis-related proteins cleaved caspase 3 (F=46.98, P=0.001 4) and caspase 3 (F=33.35, P=0.002 7). Conclusion Overexpression of TPX2 was found in TSCC tissues. Silencing of TPX2 might inhibit cell proliferation and promote cell apoptosis. TPX2 could be a new target for gene therapy of TSCC.
Objective To evaluate the clinical outcomes of all-ceramic crowns whose oral digital impressions were scanned by 3Shape Trios. Methods All the impressions were scanned by Trios and all the crowns were fabricated according to the standard procedure. The restoration quality were evaluated using modified United States Public Health Service (USPHS) criteria one year after treatment. Restoration integrity、 marginal adaptation、enamel wear、 color satisfaction and gingival index (GI) of the prostheses were evaluated according to the modified USPHS criteria. Results The clinical 1 year survival rate of 92 porcelain crowns fabricated by 3-shape Trios digital impression and made by CAD/CAM was 100%. The scored A rates of restoration integrity、 marginal adaptation、 enamel wear、 secondary caries、color satisfaction and gingival index of the prostheses were 100%、91.3%、 98%、95.6%、96.7% and 94.7% after 1 year, respectively. Conclusion The clinical outcomes of all-ceramic crowns whose oral digital impressions were scanned by 3Shape Trios and whose crowns were made by CAD-CAM are satisfying.
Objective To analyze the clinical characteristics of oral and maxillofacial space infection between the diabetic and non-diabetic patients and to explore the common pathogenic bacteria and antibiotic sensitivity of diabetic patients, to guide the clinical medication. Methods A retrospective study was conducted on 61 patients who received treatment in Qingdao municipal hospital affiliated to Qingdao university, between December 2014 and December 2016 with Oral and maxillofacial space infection. The 61 patients were divided into diabetic group and non-diabetic group. The research contented the patients'age, sex, source of infection, pathogenic bacteria, antibacterial drugs sensitivity, fasting blood glucose levels, white blood cell total and neutrophils percentage, and days of hospitalization. T test and chi-square test in SASS.19.0 software was used. Results In the 2 groups of patients, the most common etiological factor was odontogenic infection; the most easiest affected space was submandibular space. The most common pathogenic bacteria were streptococcus. Vancomycin was the most sensitive drug, then levofloxacin and cefotaxime. In addition, the diabetes patients'age, fasting blood glucose levels and hospitalization days were significantly higher than non-diabetic patients'. Conclusion For the diabetic patients with maxillofacial space infection, levofloxacin and cefotaxime was first used for the conservative treatments when the results of the bacterial culture and drug susceptibility test are not obtained. Meanwhile, according to the oral and maxillofacial anatomy, combination of anti-anaerobic agents such as Tinidazole is also suggested. But the final situation of medication is based on the result of the drug susceptibility test.
Objective To analysis the clinical and image features of temporomandibular joint (TMJ) disc calcification. Methods The patients diagnosed with TMJ disc calcification treated in School and Hospital of Stomatology, Wuhan University in the latest 10 years were collected, clinical symptom and images of these cases were analyzed, and the published literatures of TMJ disc calcification were reviewed. Results Total 2 cases of TMJ disc calcification with complete clinical data were analyzed. The symptom included mouth opening limitation, TMJ pain, open bite of the affected side molar. Calcified body were found through X-ray examination. Joint disc perforation were found during the surgery. The discs showed calcified features. Collagen hyperplasia, cartilage cells generation and calcification were found in the disc through pathological examination. Conclusion The diagnosis of TMJ disc calcification should be combined the symptom, image features and the surgery, it should be differentiated with TMJ osteoma and synovial membrane chondromasis.
Tooth avulsion is one of the most serious case of all traumatic injuries, frequently found in the immature permanent teeth. The common treatment for avulsed permanent tooth is replantation and splint fixation. However it usually results in root inflammation, root absorption and ankylosis, eventually lead to extraction. The present report describes a 8-year-old boy with two immature mandibular central incisors avulsed three hours after the accident. Replantation was performed, and the teeth were splinted. Radiographic and clinical examinations were performed during 15 months follow-up. At present, the avulsed teeth have a favorable prognosis, and remained in a stable functional position and did not reveal root inflammation, root absorption and ankylosis.
The aim of vital pulp therapy is to preserve vital, healthy pulp tissue through pulp capping or pulpotomy. Pulp-capping materials are applied to isolate infection, promote odontoblast differentiation and reparative dentine formation during the progress. Calcium silicon-based materials play significant roles in vital pulp therapy with their favorable mechanical properties, bioactivity and biocompatibility. The present paper will review current progress for these novel calcium silicon-based materials used in vital pulp therapy.
Oral cancer is a common malignant tumor in head and neck cancers, and the metastasis of cervical lymph nodes directly affects the prognosis of patients with oral cancer. Exploration and study on the detection of occult lymph nodes in patients with negative cervical lymph nodes is of great importance to improve the prognosis of patients with early oral cancer. This article reviews some progresses of occult lymph node metastasis of oral cancer in ultrasound guided fine-needle aspiration cytology (US-FNAC)、 positron emission tomography and single-photon emission computed tomography/computed tomography (SPECT/CT) fusion technology, sentinel lymph node biopsy technique (SLNB) and molecular biological detection、 nanotechnology and quantum dot technology.
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