Horizontal impacted lower third molars are often adjacent to the inferior alveolar nerve,direct extraction may cause trauma and complications,the most serious complication is inferior alveolar nerve damage.This article reports one case of horizontal impacted lower third molar adjacent to the mandibular nerve canal,the molar was extracted by minimal anchorage pulling for 1 week and then removed smoothly.

Objective:To explore the influence of psychological factors on temporomandibular disorders(TMD) in school students.Methods:52 school students aged 14-26 years with TMD classified as muscular dysfunction (MD,n =26),temporomandibular displacement(TD,n =14) and MD with TD(MD +TD,n =12),and 53 healthy adolescents as the controls were investigated.All the participants accepted TMD examination and their psychological status were tested by symptom checklist-90 (SCL-90).The patients were divided into acute(case history ≤6 months,n =32) and chronic(case history ＞6 months,n =20) groups.The psychological differences among the related groups were analyzed by SPSS 17.0 statistical software package.Results:The total and the factor scores of the TMD group were higher than those of control(P ＜ 0.05).There was no significant statistically difference between the MD group and the TD group(P ＞ 0.05).MD + TD group got higher SCL-90 total score and factor scores (except depression,phobic anxiety and Psychoticism score) than the other 2 groups (P ＜ 0.05).The acute and chronic group got similar SCL-90 total scores and factor scores (P ＞ 0.05),except somatization score (P ＜ 0.05).There was a positive correlation between the TMD pain level and total score of SCL-90.Conclusion:The psychological status have remarkable influence on the students with TMD.The pain degree of TMD is affected by psychological factors.Therefore,psychological therapy should be applied during the diagnosis and treatment of students with TMD.

Objective:To assess whether familial occurrence has an influence on the morphological characteristics of patients with nonsyndromic cleft lip and/or palate (NsCL/P).Methods:A case-control analysis was performed on the morphological characteristics of familial group and sporadic group,using medical records of 1967 patients with NsCL/P treated in the Affiliated Stomatological Hospital of Nanchang University from 2002 to 2014.Results:164 (8.34％) cases presented a positive history of cleft in their families.The cleft types,the positive familial rate of cleft lip only (CLO),cleft lip and alveolar ridge(CLA),cleft lip and palate (CLP) and cleft palate only (CPO) were 8.11％,8.54％,6.19％ and 9.65％ respectively.A positive family history of NsCL/P was associated with 0.66 times risk of CPO (P =0.036,OR =0.66,95％ CI 0.44-0.98) compared to those of CLO,CLA and CLP.In familial group of CLP,the lateral incidence of male patients was different from that of female patients (P ＜ 0.001).There was no significant difference between familial group and sporadic group on birth weights,parental child-bearing age and clinical manifestations of patients.Conclusion:Familial occurrence might have an influence on cleft type,laterality and gender of the patients with NSCL/P.

Objective:To investigate the effects of rocuronium in the intravenous anesthesia in children with cleft lip and palate repair.Methods:According to random number table,96 children with cleft lip and palate aged 1-3 years underwent general anesthesia for surgery were divided into 3 groups (n =32).The children in group A,B and C received intravenous injection of rocuronium at 0.6,0.9 and 1.2 mg/kg,respectively.The anesthesia effects were observed.Accelerometry (TOF-Watch(@) SX) was used to monitor neuromuscular transmission.Results:Intubating conditions ranged from good to excellent in all children.The onset time of anesthesia in Group C was significantly shorter(P ＜ 0.05),the duration of neuromuscular block was significantly longer in group C than in group A and B (P ＜ 0.05).The recovery index in group C was significantly longer than that in group A and B (P ＜ 0.05,A vs B,P ＞ 0.05).Muscle relaxant residual incidence in group C was higher than that in group A and B (P ＜ 0.05,A vs B,P ＞ 0.05).Conclusion:Rocuronium at 0.6 mg/kg or 0.9 mg/kg are effective for excellent tracheal intubation,with faster onset time and recovery time,low incidence of postoperative residual curarization(PORC) in children with cleft lip and palate repair.

Objective:To detect the expression levels of T cell immunoglobulin mucin-3 (Tim-3) in peripheral blood natural killer (NK) cells of patients with oral squamous cell carcinoma (OSCC) and to study their biological and clinical significance.Methods:The expression of Tim-3 in the CD3-CD56 + NK cells was examined in 72 patients with OSCC and 40 heathy controls (HC) by flow cytometry.The correlation of Tim-3 expression in NK cells with clinicopathological parameters was analyzed.Results:The proportion of CD3-CD56 + NK cells was significantly decreased in OSCC patients as compared with HC [(9.30 ± 2.52)％ vs (17.36 ± 3.15)％,P ＜ 0.001].The percentage of Tim-3 + CD3-CD56 + NK cells in OSCC patients was higher than that in HC [(14.35 ± 6.35) ％ vs (1.78 ± 0.86) ％,P ＜ 0.001].High percentage of Tim-3 + CD3-CD56 + NK cells was associated with cell differentiation,lymphatic metastasis and pathological stage of OSCC (P ＜ 0.01).Conclusion:Lower proportion of NK cells and higher level of Tim-3 in peripheral blood NK cells may play a role in the development of OSCC.

Objective:To observe the clinical effects of conservative sequence method in the treatment of anterior disk displacement without reduction(ADDWR).Methods:300 patients with ADDWR were included.200 patients were treated by conservative sequence method (including upper articular cavity lavage with single needle + injection of sodium hyaluronate gel + physical therapy + gimmick reset + oral exercise) (group 1);the other 100 were treated by injection of sodium hyaluronate gel(group 2).Maximum mouth opening (MM0) and pain visual analogue scale(VAS) were measured and compared before and after treatment.Results:In group 1 the effective rate was 95.5％,before treatment MMO was (22.90 ± 3.18) mm,VAS (5.81 ± 0.32);3 months after treatment MMO (37.05 ± 4.43) mm,VAS (1.29 ± 0.19);6 months after treatment MMO (36.29 ± 4.08) mm,VAS (1.37 ± 0.22);12 months after treatment MMO (35.76 ±3.87) mm,VAS (1.52 ±0.28),respectively.In group 2,the effective rate was 78％,before treatment MMO was(23.12 ±4.02) mm,VAS (6.11 ±0.67);3 months after treatment MMO (36.11 ±4.02),VAS (1.89 ±0.21);6 months after treatment MMO (35.49 ±3.78),VAS (2.21 ±0.32);12 months after treatment MMO (31.53 ±4.87) mm,VAS (3.88 ±0.51)mm,respectively.By statistics,all the measurments showed statistical significance(P ＜ 0.05) between 2 groups.Conclusion:Conservative sequence method is more effective in the treatment of ADDWR.

Objective:To provide imaging evidence for the treatment of anterior disc displacement without reduction by the injection of sodium hyaluronate into temporomandibular joint (TMJ).Methods:40 patients with anterior disc displacement without reduction were injected 3 times with sodium hyaluronate into the TMJ.Patient's TMJ and clinical symptoms were examined 3,9 and 12 months after treatment.The clinical parameters of Fricton's Craniomandibular Index(Fricton index),maximal mouth opening(MMO),pain intensity of a visual analog scale(VAS) and CBCT radiographic data of 48 TMJs from 40 patients were analysed.Results:The CBCT images showed that at 9 and 12 months follow-up the surface of the condylus became smooth,the density of the cortical bone and the adjacent subcortical bone increased and osteophyte in condylar head decreased(P =0.026,P =0.001).As for disc displacement without osteoarthritts,9 months after treatment condylus were moved forward(P =0.038).VAS and Fricton index were reduced(P ＜0.05),MMO was increased (P ＜ 0.05).3-12 months after treatment,there was no statistical difference of Fricton index (P ＞ 0.05).Conclusion:Injection of sodium hyaluronate into TMJ can remodel the condylar bone surface but cant make condyle back to the middle of acetabulum.

Objective:To compare the effects between Begg and pre-adjusted appliance on dentofacial morphology in Angle class Ⅱ division 1 extraction cases treated by light archwire technique.Methods:28 cases with Angle class Ⅱ division 1 who needed maximum maxillary incisor retraction were divided into 2 groups (MBT pre-adjusted and Begg group) and treated by light archwire technique.4 first premolars were extracted in all patients.Lateral cephalometric films were analyzed before and after treatment.Results:The upper incisors were intruded (0.18 ± 0.32)mm and (0.77 ± 0.91) mm in pre-adjusted and Begg group respectively (P ＜ 0.05).The other differences of cephalometric analyses between 2 groups were not significant (P ＞ 0.05).Conclusion:The effects were almost same with pre-adjusted and Begg appliances in Angle class Ⅱ division 1 extraction cases treated by light archwire technique except for that the latter is better than the former in vertical control of maxillary anterior teeth.

16 death cases of oral and maxillofacial space infection were analyzed.10 of the 16 patients were over 60 years old,the other 6 were aged 49-57 years,most of them had systemic underlying disease,and 11 of them were with diabetes mellitus.Odontogenic infection is the leading cause of maxillofacial infections(n =13).Lethal factor in oral and maxillofacial space infection is various,and comprehensive treatment should be given.

Objective:To study the expression and significance of sodium channel Nav1.6 in oral leukoplakia and squamous cell carcinoma.Methods:Immunohistochemistry and Western blot were used to detect the expression of Nav1.6 in 21 case of normal oral mucosa,32 of oral leukoplakia and 63 of oral squamous cell carcinoma(OSCC).Results:Immunohistochemical results showed that the positive rate of Nay1.6 in normal group,oral leukoplakia group and OSCC group was 6.25％,40％ and 76.74％ respectively.The expression of Nav1.6 was related to the differentiation of oral squamous cell carcinoma.Western blot results revealed that the content of Nav1.6 in normal oral mucosa,oral leukoplakia and OSCC was 0.469 ±0.015,0.545 ±0.016 and 0.848 ±0.020(P ＜0.05) respectively.Conclusion:Nay1.6 may play a role in the development of OSCC.