Parapharyngeal space (PPS) is a deep anatomical compartment in the head and neck region, containing critical structures such as the internal carotid artery and cranial nerves. Primary tumors in this area are relatively rare. Surgical resection remains the primary treatment for tumors in this region, and selecting an appropriate surgical approach is crucial for ensuring safe tumor removal and minimizing postoperative complications. Based on recent literatures and the clinical experiences of our team, this article systematically reviews and discusses the main surgical approaches based on the three-dimensional compartmentalization of the PPS, aiming to provide a reference for selecting appropriate clinical surgical strategies.
Objective: To develop a deep learning (DL)-based three-dimensional (3D) point cloud reconstruction network that utilizes the morphological features of the ipsilateral maxillary lateral incisor, canine, and premolars to predict and reconstruct the anatomical morphology of the maxillary central incisor, providing insights for personalized anterior tooth aesthetic restoration. Methods: A total of 192 intraoral scan models were collected. Exocad software was used to segment crowns of teeth #11-14. After standardizing coordinate systems in MATLAB, 182 cases were randomly selected as the training set and 10 were the test set. A dual-network architecture (morphology and pose estimation) was trained to reconstruct maxillary central incisor point clouds. Reconstructed outputs were meshed, aligned with original crowns for evaluation, and applied to incisal third defect models of tooth #11 to compare restoration outcomes among the proposed algorithm, mirroring technique, and standard database method. Results: The test set achieved a chamfer distance (CD) of 0.405, earth mover's distance (EMD) of 0.152, and a root mean square error (RMSE) of (0.128±0.030) mm. For incisal defect restoration, the proposed algorithm [RMSE：(0.128±0.030) mm] demonstrated comparable accuracy to mirroring technique [RMSE: (0.130±0.021) mm], but significantly outperformed the database method [RMSE: (0.233±0.038) mm, P<0.001]. Conclusion: The proposed 3D point cloud reconstruction network enables high-precision maxillary central incisor restoration based on adjacent tooth morphology, offering a reliable technical solution for personalized anterior dental rehabilitation.
Objective: To evaluate the accuracy of deep learning (DL) in detecting periodontal radiographic bone loss (RBL). Methods: A systematic search of the literature was conducted in PubMed, Scopus, Google Scholar, and Web of Science for relevant studies, the search covered the period from the inception of each database until March 2024, with language restrictions set to English. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included studies. Results: A total of 19 articles meeting the criteria were included for full-text screening, with 8 of them being incorporated into the Meta-analysis. The Meta-analysis results showed that the DL models achieved a sensitivity of 0.84 [95% confidence interval (CI)=0.79 to 0.90] and a specificity of 0.83 (95% CI=0.75 to 0.91) in the classification of periodontitis. The summary receiver operating characteristic-area under the curve (SROC-AUC) was 0.92 (95% CI=0.89 to 0.94). Conclusion: DL models demonstrate good accuracy and sensitivity in detecting periodontal RBL.
Objective: To investigate the effects of aging on the bone regeneration capacity of mouse jaw and the osteogenic differentiation ability of mouse embryo osteoblast precursor cells (MC3T3-E1 cells). Methods: A maxillary bone defect model was established using senescence-accelerated mice (SAMP8 mice). Micro-CT was used to analyze the bone microstructural parameters of new bone in the maxillary bone defect area of young (2-month-old) and aged (8-month-old) mice. In vitro, hydrogen peroxide (H2O2) was used to induce senescence in MC3T3-E1 cells. The expression of senescence-related genes was detected by real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting. Senescence-associated β-galactosidase (SA-β-Gal) staining was used to compare the positive area; flow cytometry was employed to analyze cell cycle distribution; alkaline phosphatase (ALP) staining and alizarin red S (ARS) staining were used to evaluate osteogenic differentiation ability; and Western blotting was applied to detect the expression levels of osteogenesis-related proteins. Results: On the 14th day after bone defect surgery, the amount of new bone in the aged group was lower than that in the young group. In vitro experiments showed that after H2O2 treatment, the expression levels of senescence-related genes and proteins in MC3T3-E1 cells were significantly increased, and the SA-β-Gal staining positive area was significantly enlarged. Cell cycle analysis revealed a significant decrease in the proportion of cells in the S and G2 phases. Meanwhile ALP and ARS staining indicated weakened osteogenic differentiation, and the expression levels of osteogenesis-related proteins, bone morphogenetic protein-2 (BMP-2) and Runt-related transcription factor 2 (Runx2) were also significantly decreased. Conclusion: Aging can inhibit bone regeneration in the mouse jaw, partly due to the decreased differentiation capacity of osteoblast precursor cells under aging conditions.
Objective: To investigate the effects of resveratrol (Res) combined with NVP-BEZ235 (BEZ235) on the proliferation, invasion, and migration of the oral mucosal malignant melanoma (OMM) cell line Mm9h-1, and to explore the underlying mechanisms. Methods: Cell viability after drug treatment was detected using the CCK8 assay to determine drug concentrations and group assignments. The following groups were established for 48-hour treatment: Control group, 100 μmol/L Res group, 1.0 μmol/L BEZ235 group, and combination group (C1 group: 100 μmol/L Res+1.0 μmol/L BEZ235). The scratch wound healing assay and Transwell assay were used to evaluate cell migration and invasion abilities, respectively. Hoechst staining was applied to observe cell death morphology, and Western blotting was performed to detect the expression levels of apoptosis-related proteins. Results: Both Res and BEZ235 alone inhibited multiple biological behaviors of Mm9h-1 cells. Compared with the Control, 100 μmol/L Res, and 1.0 μmol/L BEZ235 groups, the C1 group showed significantly reduced cell viability, invasion, and migration capabilities, along with significantly upregulated expression of apoptosis-related proteins. Conclusion: The combination of Res and BEZ235 inhibits Mm9h-1 cell survival, invasion, and migration more effectively than either agent alone, and more potently induces apoptosis.
Objective: To systematically evaluate the clinical efficacy of endoscopic versus conventional surgery for the treatment of benign submandibular gland tumors. Methods: Databases including China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), VIP, Wanfang, PubMed, EMBase, and the Cochrane Library were searched according to the search strategy, with the search period up to January 1, 2024. Two independent reviewers assessed the quality of the included studies using the Newcastle-Ottawa scale (NOS), and a Meta-analysis was subsequently performed. Results: A total of 9 studies were included, comprising 1 randomized controlled trial (RCT) and 8 non-randomized controlled trial (nRCT), with a total of 356 patients, 153 in the endoscopic group and 203 in the traditional group. Meta-analysis results indicated that the endoscopic group had a significantly longer operative time than the traditional group [weighted mean difference (WMD)=13.56 min; 95% confidence interval(CI)=9.36 to 17.75 min; P<0.001]. However, the endoscopic approach demonstrated superior outcomes in postoperative satisfaction (WMD=2.85; 95% CI=2.03 to 3.67; P<0.001), incision length (WMD=–17.60 mm; 95% CI=–30.74 to –4.47 mm; P<0.01), and intraoperative blood loss (WMD=–16.32 mL; 95% CI=–26.67 to –5.97 mL; P<0.01). No statistically significant differences were observed between the two groups in tumor diameter (WMD=–0.19 mm; 95% CI=-2.91 to 2.54 mm; P=0.89), postoperative drainage volume (WMD=–5.53 mL; 95% CI=–14.16 to 3.10 mL; P=0.21), the incidence of facial nerve injury [ (odds ratio, OR) = 0.82; 95% CI=0.25 to 2.71; P=0.74], the incidence of great auricular nerve injury (OR=2.40; 95% CI=0.36 to 16.18; P=0.37), or the average length of stay (WMD=–1.2 days; 95% CI=–3.25 to 0.84 days; P=0.25). Conclusion: Based on the current limited evidence, endoscopic surgery for benign submandibular gland tumors can significantly shorten incision length, reduce intraoperative blood loss, and improve postoperative patient satisfaction, but prolongs operative time.
Objective: To investigate the impact of extracting mandibular third molar (M3M) tooth germs via the vestibular sulcus approach on the periodontal tissue of adjacent teeth and on patient postoperative recovery, providing a reference for the clinical application of this technique. Methods: This self-controlled study included 27 patients who required bilateral M3M germ extraction and presented to the Department of Oral and Maxillofacial Surgery, Qujing Central Hospital of Yunnan Province between May 2023 and July 2024. For each patient, one side was randomly assigned (by drawing lots) to the vestibular sulcus approach (vestibular approach group), while the contralateral side was assigned to the classic angular incision approach (angular incision group). Operative time was compared between the two groups. On postoperative days 1, 3, and 7, facial swelling, degree of mouth opening limitation, and pain visual analog scale (VAS) scores were assessed. The occurrence of complications (hemorrhage, nerve injury, dry socket, adjacent tooth injury, and wound dehiscence) was recorded. Probing depth (PD) and gingival index of the adjacent teeth were compared between the two groups preoperatively, and at 1 and 3 months postoperatively. At 6 months postoperatively, cone beam CT (CBCT) was used to compare the distobuccal osseous defect depth (ODD) of the adjacent teeth between the two groups. Results: A total of 24 patients (48 tooth germs) completed all follow-ups. On postoperative day 7, there were no statistically significant differences (P>0.05) between the two groups in facial swelling, pain VAS scores, or degree of mouth opening limitation. No postoperative complications occurred in any patient. There were no statistically significant differences (P>0.05) in operative time or the adjacent teeth gingival index at 1 and 3 months postoperatively between the two groups. At 1 month postoperatively, the distobuccal PD of adjacent teeth in the vestibular approach group was essentially unchanged from the preoperative level and was significantly smaller than that in the angular incision group (P<0.01) ; by 3 months postoperatively, the difference in this indicator between the two groups was not statistically significant (P>0.05). At 6 months postoperatively, CBCT results showed that the distobuccal ODD of adjacent teeth in the vestibular approach group was significantly smaller than that in the angular incision group (P<0.001). Conclusion: The vestibular sulcus approach for extracting M3M tooth germs is more beneficial for preserving the periodontal tissues on the distal aspect of the adjacent teeth, while showing no significant difference in postoperative recovery compared to the angular incision approach.
Objective: To investigate the clinical outcomes of the partially deepithelialized forearm flap for reconstructing defects following resection of cheek malignancies. Methods: A total of 12 patients who underwent reconstruction with a partially deepithelialized forearm flap for post-resection defects of cheek malignancies in our department between June 2021 and June 2023 were selected. Postoperative follow-up ranged from 6 to 24 months. Evaluations included facial contour, mouth opening and closing function, as well as flap survival, color, and texture. Results: All 12 flaps survived completely. Facial symmetry was satisfactory, and mouth opening and closing function was unimpaired. The flaps exhibited good color match with the surrounding tissues and a soft texture. No tumor recurrence or distant metastasis was observed during the follow-up period. Conclusion: The application of the partially deepithelialized forearm flap for reconstructing defects after cheek malignancy resection achieves favorable clinical outcomes.
Objective: To investigate the clinical efficacy of decompression combined with secondary curettage for the treatment of large jaw cysts, and analyze the impact of this technique on patients' perioperative outcomes and recurrence rates. Methods: A retrospective study was conducted, collecting clinical data from 80 patients with large jaw cysts admitted to our hospital between May 2021 and September 2023. Based on the surgical approach, patients were divided into two groups: 38 patients treated with conventional curettage were assigned to the conventional curettage group, while 42 patients treated with decompression combined with secondary curettage were assigned to the study group. The two groups were compared regarding treatment effectiveness, postoperative inflammatory markers, complication rates, bone recovery status (bone formation thickness, bone density, reduction rate of the cystic cavity), and cyst recurrence rate. Quality of life was assessed using the 36-Item Short Form Health Survey (SF-36). Results: The treatment effectiveness rate in the study group (92.86%) was higher than that in the conventional curettage group (76.32%) (P<0.05). On postoperative day 3, the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) in the study group were all lower than those in the conventional curettage group (P<0.05). The postoperative complication rate in the study group (4.76%) was significantly lower than that in the conventional curettage group (21.05%) (P<0.05). At 6 months postoperatively, the bone formation thickness, bone density, and reduction rate of the cystic cavity in the study group were significantly higher than those in the conventional curettage group (P<0.001). All domain scores of the SF-36 in the study group were significantly higher than those in the conventional curettage group (P<0.05). Furthermore, the recurrence rate in the study group (2.38%) was significantly lower than that in the conventional curettage group (18.42%) (P<0.01). Conclusion: Decompression combined with secondary curettage is an effective treatment for large jaw cysts. It can effectively reduce postoperative inflammatory response, promote bone repair, improve patients' quality of life, and significantly lower the incidence of complications and recurrence.
Numerous epidemiological studies have confirmed an correlation between periodontitis and hypertension. Moderate to severe periodontitis is not only associated with an increased risk of hypertension and elevated blood pressure levels, but the hypertensive state itself may also exacerbate the degree of inflammation in periodontal tissues. This article will review the research progress on the association between periodontitis and hypertension from two aspects: The relationship between hypertension and periodontitis, and the role of periodontitis in vascular endothelial dysfunction.
γδT cells are a subset of unconventional T lymphocytes primarily distributed in peripheral tissues such as the skin, visceral organs, and mucosal cavities. As key immune cells in the periodontal tissue, γδT cells play a crucial role in maintaining periodontal homeostasis. When periodontal homeostasis is disrupted, γδT cells contribute to the progression of periodontal inflammation. During the reparative phase of periodontitis, these cells exert protective effects and mediate the repair and regeneration of periodontal tissues. This review summarizes the fundamental characteristics and primary functions of gingival γδT cells, with a particular focus on their biological roles during the progression and reparative phase of periodontitis. Additionally, it explores the potential therapeutic applications of γδT cells in the management of periodontal inflammatory diseases. Future research should aim to elucidate the functional diversity of γδT cells in the context of periodontitis and investigate the prospects of different γδT cell subsets for biotherapeutic applications in periodontal inflammation.
Neurogenic tumors originate from the Schwann cells or ganglion cells of peripheral nerves and frequently occur in the mediastinum, retroperitoneum, neck, or extremities. Those arising in the tongue are relatively rare. This article presents six cases of lingual neurogenic tumors and systematically summarizes the imaging characteristics of such tumors through a review of relevant literature.
Mucosa-associated lymphoid tissue (MALT) lymphoma is an indolent and painless malignant tumor that most commonly occurs in the gastrointestinal tract, but it is relatively rare in the head and neck region. Among head and neck cases, involvement of the parotid gland is more common, while primary sublingual gland involvement is rarely reported and can be easily confused with benign sublingual gland tumors. This article reports a case of MALT lymphoma primarily originating from the sublingual gland and discusses its clinical manifestations, etiology, and treatment through a review of relevant literature.
