Clinical and pathological aspects on some odontogenic tumors

Odontogenic tumors constitute a very diverse group of lesions that reflects the complex processes of odontogenesis. Controversies over their classification/subtyping, terminology and diagnosis have been persisted, which has direct bearings on therapeutic and/or prognostic implications.     

Can you be too old for oral implants? An update on ageing and plasticity in the oro‐facial sensorimotor system

This review focuses on the capacity of the brain for plasticity and the utility and efficacy of oral implants in helping to restore oro‐facial sensorimotor functions, especially in elderly patients. The review first outlines the components of the oro‐facial sensorimotor system which encompasses both oro‐facial tissues and a number of brain regions. One such region is the sensorimotor cortex that controls the activity of the numerous oro‐facial skeletal muscles. These muscles are involved in a number of functions including reflexes and the more complex sensorimotor functions of mastication, swallowing and speech. The review outlines the use by the brain of sensory inputs from oro‐facial receptors in order to provide for exquisite sensorimotor control of the activity of the oro‐facial muscles. It highlights the role in this sensorimotor control played by periodontal mechanoreceptors and their sensory inputs to the brain, and how oral implants in concert with the plastic capacity of the brain may, at least in part, compensate for reduced sensorimotor functioning when teeth are lost. It outlines findings of ageing‐related decrements in oro‐facial sensorimotor functions and control. The changes in oro‐facial tissues and the brain that underlie these ageing‐related functional alterations are also considered, along with adaptive and compensatory processes that utilise the brain's capacity for plasticity. The review also notes the evidence t hat rehabilitation that incorporates adjunctive approaches such as sensorimotor training paradigms in addition to oral prostheses such as implants may enhance these processes and help maintain or facilitate recovery of sensorimotor functioning in the elderly.     

Tumor microenvironment in oral cancer: novel approaches for immunotherapy

Squamous cell carcinoma of the head and neck (SCCHN), which arises from the squamous mucosal epithelium of the oral cavity, pharynx and larynx, is a major health problem in the US and other parts of the world, especially in developing countries.     

CBCT与RVG对下颌恒切牙根管形态评估的对比研究

目的:对比CBCT法与数字化X线成像法(RVG)对下颌恒切牙根管形态评估的差异。方法:对101颗离体牙进行唇舌向及近远中向数字化X线片拍摄和CBCT高清牙列模式扫描,对图像进行根管数目、Vertucci根管分型、根管钙化和根尖口开口位置的评估,并通过CBCT图像建立偏角度投照的三角函数模型,计算偏向投照的角度。结果:CBCT法显示有30颗为双根管,RVG近远中向投照显示有36颗为双根管,卡方检验显示对根管数目和Vertucci根管分型两种方法均具有显著性差异(P<0.05)。两种方法对根管钙化和根尖口开口位置的评估均不具有显著性差异。30颗双根管牙中下颌恒切牙唇舌向双根管的最大距离(LaL)在0~1.5 mm之间的,85.7%的为Vertucci III型,LaL在1.5~2 mm之间的,66.7%为Vertucci IV和V型。以根尖片上双根管显示距离为1 mm计算,LaL在1~2 mm之间的,偏向投照角度为26.6°~45.0°,LaL在0.1~1 mm之间的,偏向投照角度为45.0°~84.3°。结论:CBCT高清牙列模式扫描和RVG投照对于根管数目和Vertucci根管分型的评估具有显著性差异,对于根管钙化和根尖口开口位置的评估不具有显著性差异。LaL在1~2 mm之间时,偏角度投照的临床可操作性较强。     

Integrating other therapies with radiation for head neck cancer: search for optimal solution

Purpose: To review the role of concurrent chemoradiotherapy protocols with special emphasis on selection of appropriate chemotherapy drug, its timing and schedule with respect to radiation fractionation.     

牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形远期疗效评价

目的：评价牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形的远期疗效。方法伴牙槽骨缺损的成人错畸形3例,平均年龄29岁。经正颌-正畸联合会诊制订治疗计划,按照牙槽骨再生正畸及正颌-正畸联合治疗模式,分别进行系统治疗并随访2~3 a。结果3例患者均顺利完成治疗,面型及咬合关系获得良好改善;牙槽骨缺损区正畸牙移动到位且未见医源性牙周并发症,牙槽骨缺损区骨量增加明显且远期效果稳定。结论针对伴牙槽骨缺损的成人患者,牙槽骨再生正畸是一种较为理想的技术。     

Chemotherapy using new superselective intra-arterial infusion for advanced oral cancer

Purpose: We developed a new method of superselective intra-arterial infusion via the superficial temporal artery (HFT method: Hattori, Fuwa and Tohnai reported) and preoperatively performed daily concurrent radiotherapy and chemotherapy with docetaxel (DOC) and cisplatin (CDDP) using this method for 46 patients with stage Ⅲ, Ⅳ oral cancer.     

Navigation-guided oral and maxillofacial surgery (reconstructive and plastic, orthognathic, oncology)

Purpose: Advance in the field of compeer assisted surgery enables the surgical procedures to be less invasive and more accurate for the support of diagnosis imaging, pre-operative simulation and intraoperative navigation.     

Clinical evaluation of demineralized bone allograft in a hyaluronic acid carrier for sinus lift augmentation in humans: a computed tomography and histomorphometric study

OBJECTIVES: Natural and synthetic graft materials are used routinely in sinus floor augmentations to help support implants in atrophic maxillary ridges. This clinical study was based on the hypothesis that the clinical effectiveness of demineralized freeze-dried bone allograft/demineralized bone matrix (DFDBA/DBM) in sinus lifts varies when used in combination bone graft substitute materials. To test this hypothesis, DFDBA was used together with one of three materials: in saline plus anorganic bone (DFDBA: Bio-Oss; in hyaluronic acid (DFDBA: HY, 32 : 68, w/w; DBX alone; DBX plus Bio-Oss; and DBX plus tricalcium phosphate granules (beta-TCP). MATERIAL AND METHODS: Thirty-two sinus lift procedures, eight per group, were performed on 26 patients. Before surgery and at 8 months post-surgery when implants were placed, ridge heights were visualized by computed tomography (CT) and measured by morphometric analysis. Cores of bone were removed by trephine at the sites of implant placement; these biopsies from the graft sites were used for histomorphometric analysis. RESULTS: All 32 sinus lift elevations were successful when measured by CT, increasing from an average 2.84+/-0.2 mm before treatment to 15.2+/-0.6 mm after treatment. The percent of each biopsy that was occupied by new bone and incorporated bone graft materials varied with each treatment: DFDBA+Bio-Oss, DBX+Bio-Oss, or DBX alone was higher than that for DBX+beta-TCP by approximately 10%. When comparing only newly formed bone, DBX+beta-TCP treatment resulted in 50% less bone than the other three preparations. All grafted sites received implants as per the treatment plan for each patient. CONCLUSIONS: This study confirmed the hypothesis that new bone formation is dependent on the DFDBA formulation used and demonstrated that DBX, alone or in combination with other materials, can be used successfully for sinus floor elevation.     

氟化泡沫对正畸固定矫治患者牙周指数及牙釉质脱矿的影响

目的:探讨氟化泡沫对正畸固定矫患者牙周指数及牙釉质脱矿的影响。方法:选取2013年6月~2014年6月30例舌侧正畸治疗患者(600颗牙)为研究对象,根据入院时间分为对照组15例(297颗牙)和观察组15例(293颗牙),对照组采取常规口腔卫生措施,观察组在对照组的基础上定期使用1.23%氟化泡沫。随访12 个月,观察两组牙釉质脱矿牙位分布、脱矿指数(EDI)、菌斑指数(PLI)和出血指数(BI)。结果:牙釉质脱矿主要分布于上颌侧切牙、上颌中切牙及下颌前磨牙等;观察组牙釉质釉质脱矿率11.26%明显低于对照组17.51%(χ²=4.666,P<0.05);观察组EDI、PLI、BI等均明显低于对照组(t=9.947, 4.435, 7.789,P<0.05)。结论:舌侧正畸治疗中牙釉质脱矿发生率较高,氟化泡沫有助于减少正畸治疗中的牙釉质脱矿发生,降低牙周指数。     

Management of acute open flexor tendon injuries of the hand and wrist: basic sciences,surgical factors and rehabilitation pertinent to optimizing outcome

Flexor tendon injuries to the hand and wrist represent a significant resource burden to the UK NHS. A good understanding of tendon basic science and repair techniques is crucial for the surgeon undertaking their repair and rehabilitation. Furthermore, this is a common topic assessed in the FRCS(Orth) examination. This article will summarize the basic science relating to tendon structure, physiology and injury. Additionally, it will present key surgical and rehabilitation factors relevant to clinical outcomes.     

In vitro calibration and validation of a digital subtraction radiography system using scanned images

OBJECTIVES: To calibrate and validate a digital subtraction radiography system using scanned images for quantification of alveolar bone changes by means of computer-assisted densitometric image analysis (CADIA) in vitro. MATERIALS AND METHODS: Noise levels were determined using 10 standardized periapical radiographs of the same lower molar region in a human dry skull. For validation of the system, radiographs were taken before and after bovine bone particles in measures with increments of 2 mg weighing from 2 to 20 mg were added into each socket of three dry skulls. Radiographs were developed and scanned into a computer with a flatbed scanner. After digitization, the images were subjected to alignment, normalization and subtraction. Appropriate regions of interest (ROIs) were selected and their CADIA values were calculated for the determination of noise levels, and correlations between the CADIA values and the actual bone mass were performed. RESULTS: When the threshold value was 7, the percentage of pixels deviating from the set threshold value was small (0-11.3%). There were statistically significant correlations between the actual bone mass and the CADIA value for anterior sockets (p<0.001, r2=0.89) and posterior sockets (p<0.001, r2=0.9). For pooled data of both anterior and posterior sockets, the correlation was also statistically significant (p<0.001, r2=0.88). CONCLUSIONS: A high and statistically significant correlation between the actual bone mass and CADIA value was obtained, which suggests that the system could be suitable for the detection of small alveolar bone changes.     

伴囊肿的上颌埋伏阻生中切牙早期引流助萌治疗

目的:探讨采用引流助萌的方法对伴囊肿的上颌埋伏阻生中切牙的早期治疗。方法:选取单侧上颌中切牙埋伏阻生、处于替牙早期伴囊肿的患者8例。外科囊肿切除同时对埋伏阻生上颌中切牙引流助萌治疗。治疗前后拍摄CBCT,Dolphin11.0软件测量矫治前后阻生牙及对侧正常同名牙的冠根长度。结果:8例患者的埋伏阻生上颌中切牙平均矫治时间6.7个月。矫治后阻生牙和对侧正常同名牙的冠根长度均有生长。阻生牙冠根长度较对侧正常同名牙明显短(P<0.05)。结论:本研究所采用引流助萌方法为埋伏阻生牙的矫治提供了一个安全、有效的新途径。     

Cone beam imaging: is this the ultimate imaging modality?

This review article provides an overview of cone beam (CB) imaging technology and its role in orofacial imaging, including comparison with two-dimensional (2D) radiography and multislice computed tomography (MCT). The radiation dose levels of CB systems are discussed, with reference to those delivered by MCT and common dental 2D views. The large variation in dose levels delivered by CB systems and the importance of using ultra low-dose CB units are emphasized. Low-dose MCT protocols can be used. CB and MCT image quality are compared. CB is an essential technique that all dental and orofacial clinicians must be familiar with. Where ultra low-dose systems and protocols are used, CB imaging should be considered in day-to-day clinical practice. However, CB imaging is not the technique of choice in many clinical scenarios. Rather than replacing other modalities, CB imaging complements intraoral 2D radiography, panoramic radiography, MCT and other techniques including magnetic resonance imaging, ultrasound and nuclear medicine. MCT is a much more powerful and flexible modality and presently remains the technique of choice over CB imaging in many clinical scenarios. All radiologic examinations, including CB and MCT, should be comprehensively evaluated in entirety. The responsibilities and the radiological skill levels of clinicians involved in imaging as well as the associated ethical and medico-legal implications require consideration.     

Carotid artery resection and reconstruction: A clinical experience on 28 consecutive cases

Purpose: To analyze a single institution's experience in carotid artery resection with or without reconstruction performed as part of an oncological procedure or emergency hemostasis.     

Fabrication and characterisation of a novel biomimetic anisotropic ceramic/polymer-infiltrated composite material

Objective

To fabricate and characterise a novel biomimetic composite material consisting of aligned porous ceramic preforms infiltrated with polymer.

双槽沟被动自锁系统扭转性能的三维有限元分析

目的:采用三维有限元分析方法,研究双槽沟被动自锁系统作用于扭转牙的力学性能及变化规律。方法:选择DamonQ托槽作为研究对象,建立DamonQ及不同尺寸弓丝的三维有限元模型,根据实验分组进行装配、网格划分、参数设定及力量加载,最终分析所得数据,绘制曲线图。结果:单丝组中,扭转力矩值随弓丝尺寸的增大而增大。双丝组中,主弓丝尺寸不变,扭转力矩值随辅弓丝尺寸增大而增大;当辅弓丝尺寸相同时,扭转力矩值与主弓丝尺寸成正相关。主槽沟中弓丝尺寸一致时,单丝组扭转力矩值明显小于双丝组。结论:DamonQ托槽双丝的扭转性能明显高于单丝,合理使用辅助性水平槽沟有助于矫正牙扭转。