The use of suture to pull the lingual gingival flap in mandibular posterior dental implant surgery may damage the contralateral mouth corner of the surgical area.This study explored the effectiveness of sterile wound dressing in preventing the friction injury by suture in oral implant surgery.A total of 506 patients were included,the sterile wound dressing was used in the test group(n=363)but not in the control group(n=143).The postoperative situation of the patients was analyzed,validated and received holistic care after implant surgery.The results suggest that the use of sterile wound dressing can shorten the operation time,prevent suture friction of mouth corer,simplify post-operative care and improve patient satisfaction for posterior dental implant surgery.

OBJECTIVES: This study aimed to analyze the application value of a modified tragus edge incision and transmasseteric anteroparotid approach to condyle reconstruction. METHODS: Condyle reconstruction was performed in 16 patients (9 females and 7 males) with modified tragus edge incision and transmasseteric anteroparotid approach. After regular follow-up, the function of condyle reconstruction was evaluated by clinical indicators, such as parotid salivary fistula, facial nerve function, mouth opening, occlusal relationship, and facial scar. The morphology of rib graft rib cartilage was evaluated by imaging indicators, such as panoramic radiography, CT, and three-dimensional CT image reconstruction. RESULTS: At 6-36 months postoperative follow-up, all patients had good recovery of facial appearance, concealed incisional scar, no parotid salivary fistula, good mouth opening, and occlusion. One case had temporary facial paralysis and recovered after treatment. Radiographic evaluation further showed that costochondral graft survived in normal anatomic locations. CONCLUSIONS The modified tragus edge incision and transmasseteric anteroparotid approach can effectively reduce parotid salivary fistula and facial nerve injury in condylar reconstruction. The surgical field was clearly exposed, and the incision scar was concealed without increasing the incidence of other complications. Thus, this approach is worthy of clinical promotion.
Male ; Female ; Humans ; Mandibular Condyle/surgery* ; Cicatrix/surgery* ; Fracture Fixation, Internal/methods* ; Mandibular Fractures/surgery* ; Oral Surgical Procedures/methods* ; Treatment Outcome

The significant clinical feature of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is the exposure of the necrotic jaw. Other clinical manifestations include jaw pain, swelling, abscess, and skin fistula, which seriously affect the patients' life, and there is no radical cure. Thus, new methods need to be found to prevent the occurrence of BRONJ. Here, a novel nanoparticle, tFNA-KLT, was successfully synthesized by us, in which the nanoparticle tetrahedral framework nucleic acid (tFNA) was used for carrying angiogenic peptide, KLT, and then further enhanced angiogenesis. TFNA-KLT possessed the same characteristics as tFNA, such as simple synthesis, stable structure, and good biocompatibility. Meanwhile, tFNA enhanced the stability of KLT and carried more KLT to interact with endothelial cells. First, it was confirmed that tFNA-KLT had the superior angiogenic ability to tFNA and KLT both in vitro and in vivo. Then we apply tFNA-KLT to the prevention of BRONJ. The results showed that tFNA-KLT can effectively prevent the occurrence of BRONJ by accelerating angiogenesis. In summary, the prepared novel nanoparticle, tFNA-KLT, was firstly synthesized by us. It was also firstly confirmed by us that tFNA-KLT significantly enhanced angiogenesis and can effectively prevent the occurrence of BRONJ by accelerating angiogenesis, thus providing a new avenue for the prevention of BRONJ and a new choice for therapeutic angiogenesis.
Angiogenic Proteins/therapeutic use* ; Bisphosphonate-Associated Osteonecrosis of the Jaw/prevention & control* ; Endothelial Cells ; Humans ; Nanoparticles ; Nucleic Acids/therapeutic use*

BACKGROUND:Mandibular fractures often harm patient’s work and life. Intermaxilary traction nail with smal/mini-titanium plate, relative to traditional dental arch splint combined with smal/mini titanium plate treatment alone, is characterized by short treatment time and good fixation effect, which can improve the maxilofacial dysfunction and promote the early completion of the treatment.
OBJECTIVE:To explore the curative effect of intermaxilary traction nail with mini-titanium plateversus dental arch splint combined with smal/mini-titanium plate on mandibular fractures
METHODS:Ninety cases of mandibular fractures hospitalized at the Department of Oral and Maxilofacial Surgery, Stomatological Hospital of Southwest Medical University in China from July 2011 to May 2015 were enroled in this study. These patients were equivalently randomized into control group subjected to dental arch splint combined with smal/mini-titanium plate and observation group subjected to intermaxilary traction nail with mini-titanium plate. Al the patients were folowed up for 4-6 months. Curative effects, including excelent and good rate and total efficiency, were compared between the two groups. Maxilofacial function and incidence of adverse reactions were observed and recorded, respectively, to analyze the experimental data and assess their clinical values.
RESULTS AND CONCLUSION:The total efficiency and the maxilofacial function were significantly better in the observation group than the control group (P < 0.05). Plaque and debris index was increased significantly in the control group compared with the experimental group before and after treatment (P < 0.05). The gingival index had no significant changes in the observation, but it was increased significantly in the control group before and after treatment (P< 0.05). The number of cases of adverse reactions was significantly less in the experimental group than the control group (P < 0.05). These results show that the effect of internal fixation with intermaxilary traction nail combined with smal/mini-titanium plate mini titanium plate and mini titanium plate was good, safe and reliable.

Objective To investigate the clinical effect of individual prefabricated reconstructive titanic plate combined with vascularized iliac bone-muscular flap for reconstruction of mandibular defects.Methods From Aug.2010 to Dec.2014,12 cases with mandibular tumor received preoperative maxillofacial CT scans and 3-dimensional reconstruction.Based on the CT results,mirror imaging technology was used to simulate the reconstruction of the defect at affected side.The individual reconstructive titanium plate was prefabricated on the model.The iliac bone-muscular flap was designed according to the defect shape and size,combined with reconstructive plate.All patients underwent CT scan and oral curved surface tomography postoperatively.The maxillofacial function and appearance were also evaluated.Results According to the CT scan and curved surface tomography,the 12 iliac bone-muscular flaps survived completely with good bone union and good condyle position.Both the functional and cosmetic results were satisfactory.There was no complication on the donor sites.Conclusions Individual prefabricated reconstructive titanic plate combined with vascularized iliac bone-muscular flap provides an precise method for reconstruction of mandibular defects.The cosmetic and functional results could be expected.

Objective To investigate the clinical effect of individual prefabricated reconstructive titanic plate combined with vascularized iliac bone-muscular flap for reconstruction of mandibular defects.Methods From Aug.2010 to Dec.2014,12 cases with mandibular tumor received preoperative maxillofacial CT scans and 3-dimensional reconstruction.Based on the CT results,mirror imaging technology was used to simulate the reconstruction of the defect at affected side.The individual reconstructive titanium plate was prefabricated on the model.The iliac bone-muscular flap was designed according to the defect shape and size,combined with reconstructive plate.All patients underwent CT scan and oral curved surface tomography postoperatively.The maxillofacial function and appearance were also evaluated.Results According to the CT scan and curved surface tomography,the 12 iliac bone-muscular flaps survived completely with good bone union and good condyle position.Both the functional and cosmetic results were satisfactory.There was no complication on the donor sites.Conclusions Individual prefabricated reconstructive titanic plate combined with vascularized iliac bone-muscular flap provides an precise method for reconstruction of mandibular defects.The cosmetic and functional results could be expected.

OBJECTIVEThe aim of this study was to investigate the value of free anterolateral thigh myocutaneous flap (ALTMF) and computed tomography angiography (CTA) for the reconstruction of mouth-floor defects after the resection of middle-late stage carcinoma of the mouth floor.

METHODSSixteen cases of middle-late stage carcinomas of the mouth floor underwent radical resection, and mouth-floor and tongue defects were reconstructed with ALTMF. CTA was applied to plan the lateral circumflex femoral artery (LCFA) and its perforating vessel, which was verified during the operation.

RESULTSThe position of the perforating vessel in the operation was fully consistent with that designed by the preoperative CTA. All 16 flaps completely survived. The appearance and function of all cases were both satisfactory. All donor sites were primarily closed and healed without functional morbidity. During the follow-up period of 6-36 months, 15 cases survived with acceptable aesthetic and functional results in mouth floor and tongue reconstruction, except for 1 case (T4N2M0) that died of metastasis carcinoma 10 months after operation.

CONCLUSIONCTA can accurately locate the LCFA and artery perforator. Preoperative perforator planning using CTA in ALTMF transplantation is a reliable and useful method thatresults in safe operation with optimal outcome. The ALTMF is an ideal choice for the reconstruction of soft tissue defects after the resection of middle-late staie carcinoma of the mouth floor

Angiography ; Carcinoma ; Free Tissue Flaps ; Humans ; Mouth Floor ; Myocutaneous Flap ; Patient Care Planning ; Reconstructive Surgical Procedures ; Thigh ; Tomography ; Tongue

OBJECTIVEThis study aims to evaluate the effect of customized titanium mesh, which was designed by mirror imaging and rapid prototyping technique, with Medpor applied for orbital fracture with enophthalmos.

METHODSOrbital axial, coronal, and sagittal CT scan, and three-dimension CT examination were performed routinely in. 18 cases of orbital fracture with enophthalmos preoperatively. Based on the CT data, prosthesis model was designed by reverse engineering and rapid prototyping technique. The customized titanium mesh and Medpor were applied for orbital reconstruction and enophthalmos correction. Orbital reduction and globe projection were evaluated by postoperative CT scan and clinical follow-up visits.

RESULTSCT scans revealed that the customized titanium mesh with Medpor had great accuracy to reconstruct the orbital fracture and correct the enophthalmos in all patients without serious complications. The eye and facial appearance and function recovered significantly. No serious complication occurred in the operation and after operation.

CONCLUSIONThe customized titanium mesh, based on mirror imaging and rapid prototyping technique, can accurately reconstruct the orbital fractures with enophthalmos. The application of Medpor can effectively correct enophthalmos and eyeball mobility malformation.

Enophthalmos ; therapy ; Facial Bones ; Humans ; Orbit ; Orbital Fractures ; surgery ; Polyethylenes ; Postoperative Period ; Prostheses and Implants ; Reconstructive Surgical Procedures ; Surgical Mesh ; Titanium ; Tomography, X-Ray Computed

ObjectiveThis?study?aims?to?evaluate?the?effect?of?customized?titanium?mesh,?which?was?designed?by?mirror?imaging?and?rapid?prototyping?technique,?with?Medpor?applied?for?orbital?fracture?with?enophthalmos.?Methods???Orbital?axial,?coronal,?and?sagittal?CT?scan,?and?three-dimension?CT?examination?were?performed?routinely?in?18?cases?of?orbital?fracture?with?enophthalmos?preoperatively.?Based?on?the?CT?data,?prosthesis?model?was?designed?by?reverse?engineering?and?rapid?prototyping?technique.?The?customized?titanium?mesh?and?Medpor?were?applied?for?orbital?reconstruction?and?enophthalmos?correction.?Orbital?reduction?and?globe?projection?were?evaluated?by?postoperative?CT?scan?and?clinical?follow-up?visits.?Results???CT?scans?revealed?that?the?customized?titanium?mesh?with?Medpor?had?great?accuracy?to?reconstruct?the?orbital?fracture?and?correct?the?enophthalmos?in?all?patients?without?serious?complications.?The?eye?and?facial?appearance?and?func-tion?recovered?significantly.?No?serious?complication?occurred?in?the?operation?and?after?operation.?Conclusion???The?custo-mized?titanium?mesh,?based?on?mirror?imaging?and?rapid?prototyping?technique,?can?accurately?reconstruct?the?orbital?fractures?with?enophthalmos.?The?application?of?Medpor?can?effectively?correct?enophthalmos?and?eyeball?mobility?malformation.