28 October 2024, Volume 34 Issue 5
    

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    Critical Review
  • WU Min, YIN Heng, HUANG Hanyao, SHI Bing, LI Chenghao
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 331-335. https://doi.org/10.12439/kqhm.1005-4979.2024.05.001
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    [Abstract] Objective: To evaluate the clinical effect of carbon dioxide fractional laser in early treatment of postoperative scar of primary cleft lip. Methods: A total of 24 children who had undergone primary cleft lip repair in the treatment group were treated with carbon dioxide fractional laser within three months after operation, and 24 children who had undergone primary cleft lip repair in the control group were not treated with laser after operation. Based on the subjective assessment by comparing photographs before and after the treatment and the objective assessment using Vancouver scar scale (VSS) scoring method, the scar conditions of the two groups were compared one year after laser therapy. Results: The total effective rate of the treatment group was 91.7% after the completion of the whole course of 4 treatments after 1 year, and the difference between the two groups was statistically significant (P<0.05). The objective assessment results showed that the difference between the two groups was statistically significant (P<0.05). Conclusion: Carbon dioxide fractional laser is effective in the early treatment of postoperative scar of primary cleft lip, which is worthy of clinical application.
  • Basic Scientific Study
  • HU Ziyue, ZHANG Shuai, SUN Yao
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 336-341. https://doi.org/10.12439/kqhm.1005-4979.2024.05.002
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    Objective: To explore the changes in condyle cartilage development and primary ciliary gene expression after changes in masticatory force. Methods: Three-week-old C57BL/6J male mice were divided into 3 groups, and they were fed with normal diet (ND) for 2 weeks, soft diet (SD) for 2 weeks, and fed with 1 week of soft diet than 1 week of re-normal diet (RND). After collecting the samples, safranin O-fast green staining, toluidine blue staining, Masson staining, alkaline phosphatase (ALP) staining, and collagen typeⅡ(COL2) immunofluorescence staining were performed to observe changes in the condylar cartilage and subchondral bone. Primary ciliary gene expression was detected by real-time quantitative polymerase chain reaction (RT-qPCR). Results: Compared with the ND group, the SD group has thinner condyle cartilage, less extracellular matrix, and subchondral bone structure has changed. The primary cilia gene expression (Ift88, Ift140, Ptch1, Smo, Gli1) was decreased. Compared with the SD group, the above changes recovered in the RND group. Conclusion: Changes of masticatory force during growth will affect the development of condyle cartilage and primary ciliary gene expression in mice.
  • JIAO Yi, SUN Xinrong, LIU Weicai
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 342-349. https://doi.org/10.12439/kqhm.1005-4979.2024.05.003
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    [Abstract] Objective: To explore the role and mechanism of fibroblast growth factor 13 (FGF13) in the repair of inferior alveolar nerve injury. Methods: To establish the model of inferior alveolar nerve injury in SD (Sprague-Dawley) rats. RNA from inferior alveolar tissue samples was collected 1, 3, 7 days after injury. Real-time quantitative polymerase chain reaction (RT-qPCR) was performed to detect the transcription expression levels of FGF13 gene at different time points after injury. Primary trigeminal nerve cells of neonatal SD mice were extracted and divided into experimental group and control group, transfected with FGF13 overexpressed plasmid and control plasmid, respectively. 3 days after successful transfection, cell RNA was extracted to detect the gene expression level of neurotrophin by RT-qPCR. Trigeminal nerve cells were stained with Neun and βⅢ-Tubulin nerve immunofluorescence, and the axon length of nerve cells was observed by laser scanning confocal microscope. ND7/23 nerve cells were divided into overexpression group (ND7/23-FGF13) and control group (ND7/23-vector), transfected with FGF13 overexpression lentivirus and control virus, respectively. Stable transmutation strains were screened out by purinomycin, and FGF13 protein immunofluorescence staining and JC-1 mitochondrial membrane potential fluorescence probe staining were performed. Extract cell RNA, then RT-qPCR was used to detect the expression of mitophagy related genes. Results: The expression level of FGF13 was significantly increased at 1 day after inferior alveolar nerve injury, decreased at 3 days after injury, and decreased to an equivalent level to the control group at 7 days after injury. Compared with the control group, the expression of FGF13, nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and other factors increased in the experimental group. In the lentivirus overexpression group, FGF13 protein was more densely distributed in the nucleus, mitochondrial membrane potential was significantly increased, and the expression of mitochondrial autophagy related genes was increased. Conclusion: After inferior alveolar nerve injury, the expression level of FGF13 is transiently increased, which may have potential significance for the repair process of inferior alveolar nerve. Overexpression of FGF13 in trigeminal nerve cells can promote axonal elongation of nerve cells. The underlying mechanism may be related to the regulation of mitochondrial function and the promotion of mitochondrial homeostasis.
  • LIU Xiao, SUN Jiangwei, ZHOU Jing
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 350-356. https://doi.org/10.12439/kqhm.1005-4979.2024.05.004
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    Objective: To observe the methylation and protein levels of glutathione peroxidase 3 (GPX3) in malignant pleomorphic adenoma (MPA) tissue and its clinical significance. Methods: A total of 55 cases of salivary gland pleomorphic adenoma (SPA), 24 cases of MPA, and 55 cases of normal glandular tissue from patients who underwent surgical treatment at the Second Affiliated Hospital of Xinjiang Medical University from January 2021 to January 2023 were selected.  Immunohistochemical method was used to detect the expression of GPX3 protein in tissues. Methylation specific polymerase chain reaction (MSP) method was used to detect the degree of GPX3 methylation in tissues. The relationship between clinical pathological features and methylation was analyzed. Human malignant pleomorphic adenoma cell line SM-AP1 was selected and transfected with GPX3 overexpression vector and empty vector, and they were divided into Vector group and OE-GPX3 group.Real-time quantitative polymerase chain reaction(RT-qPCR) and western blotting were used to detect GPX3 mRNA and protein expression. CCK8 was used to detect cell proliferation ability. Transwell chamber was used to detect cell invasion ability. Results: The positive rate of GPX3 protein in normal glandular tissues (90.9%, 50/55) was higher than that in SPA (56.4%, 31/55) and MPA (29.2%, 7/24) (P<0.001). The proportion of GPX3 protein methylation in normal glandular tissues (7.3%, 4/55) was lower than that in SPA tissues (34.5%, 19/55) and MPA tissues (66.7%, 16/24) (P<0.001). The methylation level of GPX3 was related to TNM stage, differentiation degree, and proportion of malignant components in MPA patients (P<0.05). The positive rate of GPX3 protein was related to TNM stage and the proportion of malignant components (P<0.05). Compared with the Vector group, the OE-GPX3 group showed a statistically significant increase in the mRNA and protein expression levels of GXP3, optical density values at 48 and 72 hours, and the number of invasive cells were decreased, and the difference was statistically significant (P<0.01). Conclusion: The GPX3 gene in MPA has a high degree of methylation initiation, which is negatively related to TNM stage, differentiation, and proportion of malignant components. It has the potential to become a warning molecular indicator for diagnosing malignant pleomorphic adenoma and a gene regulatory target in clinical treatment.

  • GAO Rui, GUO Lei, PENG Bo, JIA Jun
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 357-364. https://doi.org/10.12439/kqhm.1005-4979.2024.05.005
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    Objective: To analyze the expression of apoptosis-linked gene-2 (ALG2) in oral squamous cell carcinoma (OSCC) tissues and cell lines and its correlations with the clinicopathological features and prognosis of patients. Methods: The expression of ALG2 in 5 pairs of fresh OSCC tissues, paracancerous normal tissues, OSCC cell lines and human oral keratinocytes (HOK) were detected by real-time quantitative polymerase chain reaction (RT-qPCR). The expression levels of ALG2 in paraffin-embedded OSCC tissues and adjacent normal tissues specimens of 128 patients with OSCC were detected by immunohistochemistry (IHC). The correlation of ALG2 expression in OSCC tissues with the clinicopathological features and survival time of patients were analyzed. The expression of ALG2 in OSCC tissues and its diagnostic, prognostic value were detected in TCGA database. Results: The expression of ALG2 in OSCC tissues and cell lines was significantly higher than those in paracancerous tissues and HOK cells (P<0.05). The overall survival, disease free survival and progression-free survival of OSCC patients in the group with low ALG2 expression were significantly higher than those in the ALG2 high expression group (P<0.05). T stage, lymphatic metastasis, and ALG2 expression were all factors affecting the prognosis of OSCC patients (P<0.05). ALG2 expression was an independent predictor of the prognosis of OSCC patients (P<0.01). ALG2 may have some diagnostic value for OSCC [area under the curve (AUC)=0.807]. Conclusion: ALG2 is highly expressed in OSCC and it is associated with unfavorable prognosis of the patients, and it may have some diagnostic value for OSCC.
  • Clinical Study
  • ZHAO Yuan, LÜ Jilian, YE Keqiang, LIN Nan, PEI Fei
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 365-370. https://doi.org/10.12439/kqhm.1005-4979.2024.05.006
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     Objective: To investigate the diagnostic and prognostic value of neutrophil gelatinase-associated lipocalin (NGAL) and chitinase protein 40 (YKL-40) levels in patients with oral squamous cell carcinoma (OSCC). Methods: A total of 114 patients with OSCC admitted to our hospital from March 2017 to September 2020 were selected as the study objects (OSCC group), and 118 patients with benign tumor lesions in our hospital during the same period were selected as the control group. Serum levels of NGAL and YKL-40 were detected by enzym-linked immunosorbent assay (ELISA). The diagnostic value of serum NGAL and YKL-40 levels in OSCC was analyzed by receiver operating characteristic (ROC) curve. The prognosis of OSCC patients within 3 years after discharge was collected. Kaplan-Meier method was used to analyze the relationship between serum NGAL and YKL-40 levels and 3-year prognosis of OSCC patients. Cox proportional risk regression model was used to analyze the risk factors affecting the 3-year prognosis of OSCC patients. Results: Serum NGAL and YKL-40 levels in OSCC group were significantly higher than those in control group (P<0.001). The area under the curve (AUC) of serum NGAL, YKL- 40 and combined OSCC were 0.716, 0.744 and 0.791, respectively, and the AUC of combined diagnosis was better than that of single detection (P=0.008, 0.047). There was no significant difference in the expression levels of serum NGAL and YKL-40 in OSCC patients with different age, gender, smoking history and disease site (P>0.05). The expression levels of serum NGAL and YKL-40 in patients with TNM stage Ⅲ to Ⅳ , tumor diameter ≥3 cm and lymph node metastasis were significantly higher than those in patients with TNM stageⅠ to Ⅱ , tumor diameter <3 cm and no lymph node metastasis (P<0.001). The 3-year survival rate of patients with low expression of NGAL was higher than that of patients with high expression of NGAL, and the 3-year survival rate of patients with low expression of YKL-40 was higher than that of patients with high expression of YKL-40 (P<0.05). NGAL and YKL-40 were risk factors for the prognosis of OSCC patients (P<0.001). Conclusion: Serum levels of NGAL and YKL-40 were elevatedin OSCC patients, both of which had certain diagnostic value for OSCC and were related to the prognosis of patients.
  • Oral Implants
  • LI Jing, LI Chenxi, PEI Pei, CHEN Cheng, GONG Zhongcheng
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 371-378. https://doi.org/10.12439/kqhm.1005-4979.2024.05.007
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    Objective: To compare the distribution characteristics of biochemical stress on two techniques of zygomatic implant (ZI), sinus slot (SS) and extra sinus (ES), in combination with conventional implants respectively, and to provide theoretical basis for functional restoration of severe atrophic maxilla. Methods: Finite element analysis (FEA) models were constituted based on high-resolution computed tomography (CT) scanning data of a patient. ZIs were virtually placed into models with SS or ES techniques combined with two or four conventional implants. The von Mises stress values in implants and the principal stress values in alveolar bone were analyzed. Results: The highest von Mises stress was in the configuration of 2 conventional implants and 2 ZIs with ES technique (292 MPa). The lowest von Mises stress level in ZIs was in the configuration of 4 conventional implants and 2 ZIs with the SS technique (184 MPa). The highest maximum principal stress was in the configuration of 2 conventional implants and 2 ZIs with SS technique (31 MPa). The lowest maximum principal stress was in the configuration of 4 conventional implants and 2 ZIs with ES technique (12 MPa). The lowest minimum principal stress was in the configuration of 4 conventional implants and 2 ZIs with the SS technique (|-58| MPa). The highest minimum principal stress value in bone was in the configuration of 2 conventional implants and 2 ZIs with ES technique (|-81| MPa). Conclusion: Two ZIs with the SS technique and four conventional implants may be biomechanically safer for the rehabilitation of severe atrophic maxilla.
  • Oigital Technology
  • HOU Xiaoru, HU Xiaoyi, LI Yanqiu, LI Lifeng, TU Junbo, XING Xiaotao
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 379-385. https://doi.org/10.12439/kqhm.1005-4979.2024.05.008
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    Objective: To explore the feasibility of extraction of mandibular third molars with cystic lesions under the guidance of a dynamic navigation system (DNS). Methods: Retrospectively analyzed hospitalized patients with lower impacted mandibular third molars in Hospital of Stomatology, Xi'an Jiaotong University from December 15, 2022 to April 15, 2023. According to the inclusion criteria, seven patients with the complex mandibular third molars accompanied cystic lesions, which was tightly adjacent to the inferior alveolar canal were included. All the CT imaging data were imported into the DNS and completed the navigation design. Then the molar were extracted, and cyst was removed under the guidance of navigation. The surgical condition and postoperative recovery state were further analyzed, focusing on the symptoms of postoperative inferior alveolar nerve injury (IANI). Results: All patients' wounds healed uneventfully with the application of DNS and the patients had no symptoms of IANI. Conclusion: The DNS technology determines the operation position in real time, which reduces the damage of the inferior alveolar neural canal and reduces the risk of inferior alveolar nerve damage.
  • Clinical Report
  • GUO Yanjun, YAN Wei, CUI Zekun, CHEN Yong, WEN kai, HU Yaqi
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 386-392. https://doi.org/10.12439/kqhm.1005-4979.2024.05.009
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    Objective: To introduce the surgical technique of temporomandibular joint disc anchoring through a modified tragus incision. Methods: From February 2017 to October 2021, 264 patients (328 sides of joints) with advanced anterior disc displacement without reduction (ADDWoR) admitted to our hospital were treated with temporomandibular joint disc anchorage using a modified tragus approach. The specific method was as follows: Use a modified intraauricular approach to separate the superficial temporal fascia and the deep and superficial layers of the deep temporal fascia, as well as the joint capsule, cut the joint capsule at the root of the zygomatic arch, expose the joint disc, using a Mini Mitek anchor screw to fix it at the posterior and lower pole of the condylar process, and using two Orthocor sutures for horizontal mattress suture to reposition the anterior displaced joint disc. Magnetic resonance imaging (MRI) of the temporomandibular joint was performed before and within 7 days after surgery. The facial nerve condition was observed from 1 to 7 days after surgery, follow-up MRI was performed 3 months after surgery, and the mouth opening degree was recorded at 1 week, 1 month, and 3 months after surgery. The visual analog scale (VAS) was used to record the relief of temporomandibular joint pain in patients at 3 months after surgery. The vancouver scar scale was used to evaluate the scar condition in the surgical area at 3 months after surgery. Results: According to the evaluation of postoperative MRI, 306 joints (249 cases) were evaluated as "excellent", 20 joints (14 cases) were evaluated as "good", and 2 joints (one case) were evaluated as "poor". The successful reduction rate was 99.39% (326/328 sides). Only one patient evaluated as "poor" after surgery, accounting for 0.61% (2/328 sides). At the 3-month follow-up after surgery, all patients showed improvement in limited mouth opening, with pain scores below 2 and scar evaluations below 3. Conclusion: Improving the concealed position of the incision inside the tragus and achieving good results in the reduction of the temporomandibular joint disc is a widely applicable surgical approach for temporomandibular joint disc anchoring.

  • Review
  • JIANG Xue, WANG Zuolin
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 393-396. https://doi.org/10.12439/kqhm.1005-4979.2024.05.010
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    The impact of mechanical force stimulation on bone metabolism is currently garnering significant scholarly interest. As scientific inquiry progresses, the focus of these studies has increasingly shifted towards a more granular level of analysis. Recent years, researchers are now examining this phenomenon from various perspectives, including the influence of differing mechanical properties, force magnitudes, frequencies, cell types, and underlying molecular mechanisms on bone metabolism.Given the intricate nature of this process, this article seeks to provide a comprehensive overview of the advancements in research pertaining to the modulation of bone metabolism through the alteration of mechanical stimuli or the targeting of specific cell types and receptors, in order to provide a reference for further research.
  • LU Zhengkuan, LIN Shuxian, SU Jiansheng
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 397-400. https://doi.org/10.12439/kqhm.1005-4979.2024.05.011
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    As a tissue engineering restorative material, hydrogel possesses outstanding biocompatibility, degradability and plasticity. Due to the lack of appropriate pore characteristics, the proliferation, migration and angiogenesis of cells inside and outside the gel are limited, which seriously affect the results of tissue engineering. Therefore, the preparation of macroporous structure has become a research focus on modification of hydrogel. In this paper, the effect of pore characteristics on biological behavior of scaffolds and the prepared methods of macroporous structure in recent years are reviewed.
  • YANG Li, ZHANG Xueming, KANG Feiwu
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 401-404. https://doi.org/10.12439/kqhm.1005-4979.2024.05.012
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    Decompression is a surgical method for the preservation treatment of large jaw cysts, and a cyst plug with excellent performance is a necessary condition to ensure the therapeutic effect of this method. Making drainage port through cyst plug, balancing the pressure inside and outside the cyst cavity, and washing with postoperative physiological saline can effectively reduce the volume of the cyst cavity, and reduce the risks of nerve injury, adjacent tooth and tooth germ injury and pathological fracture of jaw caused by traditional radical surgery. In this paper, the classification and application of common cyst plugs after fenestration decompression of large jaw cysts, and the application of cyst plugs combined with negative pressure suction in recent years are reviewed.
  • Case Report
  • SUN Xu, LI Ning, ZHANG Jin, LI Xiangjun
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 405-407. https://doi.org/10.12439/kqhm.1005-4979.2024.05.013
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    Gingival amyloidosis represents the deposition of amyloid substances within the gingiva. This article reports a case of gingival amyloidosis treated at our hospital, discussing its clinical presentation, imaging characteristics, pathological features, treatment, and prognosis, with the aim of providing clinical physicians with insights and treatment guidelines for the disease.
  • ZHANG Xin, DI Ruiling, LI Cong, WANG Ning, LI Xiangchun, LU Tongtong
    《Journal of Oral and Maxillofacial Surgery》. 2024, 34(5): 408-412. https://doi.org/10.12439/kqhm.1005-4979.2024.05.014
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    Plunging ranulas are relatively rare cystic mass in the neck, which are mucous extravasation or retention pseudocysts from the sublingual gland, without the epithelial linings. They plunge inferiorly into the neck by extending beyond the free edge of the mylohyoid muscles or through the dehiscences of the muscles. We report a case of plunging ranula treated in our hospital, with recurrence seven months after the intraoral sublingual gland excision. The literatures associated with pathogenesis, clinical presentation, differential diagnosis, surgical approach and recurrent causes are reviewed.