Objective: To investigate the diagnosis, treatment and prognosis of nonodontogenic periapical lesions and to provide a reference for clinical diagnosis and treatment. Methods: A case of a patient with right upper molar pulp with apical penetration and local occlusion admitted to the West China Stomatological Hospital of Sichuan University was retrospectively analyzed, and the curative effect of microapical surgery and pith preservation was also analyzed. Results : The imaging features of tooth 16 showed periradicular radiolucency combined with local radiopaque lesions around the distal buccal apical area. Endodontic microsurgery was performed under local anesthesia. Soft tissue coverage was observed in the distal buccal apical area during the surgery, and no radiopaque tissue was detected. The distal buccal root apex was cut by 3 mm, and mineral trioxide aggregate was used for root-end backfilling. The postoperative pathological results revealed fibrous connective tissue. One-week recall X-ray examination showed tight root-end backfilling and no periradicular radiolucency; an electrical test of pulp vitality showed positive results. The four-year follow-up showed that there was no discoloration in tooth 16 and no significant difference in thermal and electrical tests of pulp vitality compared with control teeth. Combining the clinical manifestations, imaging features, surgical exploration results and pathological reports, the case was most likely to be cemental hypoplasia. Through the literature review, the treatment and healthy pulp preservation of such cases by endodontic microsurgery under the premise of preserving teeth has not been reported. Conclusion For maxillary posterior teeth with periapical lesions but healthy pulp, accurate estimation of pulp status, endodontic microsurgical exploration and application of bioactive materials can achieve vital pulp preservation while removing the lesions.

Objective:To explore the tricuspid annular plane systolic excusion(TAPSE) in children with left-to-right shunt after congenital heart disease surgery and to understand the early systolic function of right heart in thesepatient.Methods:From June 2018 to December 2018, a prospective study was conducted in 20 infants after repair of left-to-right shunt congenital heart disease, including 10 males(50%) and 10 females(50%) , aged from 1 to 12 months, with a median of 4.5(2.0, 6.8) months, a body mass of 3.0-9.0 kg with median of 6.0(3.7, 7.7) kg.On the first postoperative day, blood was taken from central venous for N-terminal pro-B-type natriuretic peptide(NT pro-BNP) test, TAPSE and left ventricular ejective fraction(LVEF) was measured by echocardiography.The effects of aortic occlusion time, cardiopulmonary bypass time, preoperative pneumonia and preoperative heart failure on TAPSE were compared. The relationship between TAPSE and heart rate, systolic pressure, central venous pressure, vasoactive drug score, endotracheal intubation time, detention time in intensive care unit, NT pro-BNP and LVEF after operation was analysed.Results:The aortic cross-clamping time was 15-87 minutes, with median 31(28, 50) minutes. The cardiopulmonary bypass time was 35-117 minutes, with an average of(68±22)minutes. The time of tracheal intubation was 4-117 hours, with an average of(50±35) hours. The stay time in CICU was 1-14 days, with a median of 5(2, 7) days.The LVEF was 0.18-0.66, with median 0.53(0.42, 0.57). The TAPSE was 2.0-10.0 mm, with an average of(5.2±2.0) mm. On the first day after operation, NT pro-BNP was 1 548-35 000 pg/ml, with an average of(9 446±8 130) pg/ml.TAPSE was negatively correlated with postoperative intubation time( r=-0.576, P= 0.007) and detention time in ICU( r=-0.765, P=0.000), and positively correlated with postoperative LVEF( r=0.461, P=0.041)( P<0.05). TAPSE was negatively correlated with heart rate( r=-0.303, P=0.193), central venous pressure( r=-0.425, P=0.062), vasoactive drug score( r=-0.418, P=0.067) and NT Pro BNP( r=-0.348, P=0.132), and positively correlated with systolic pressure( r=0.146, P=0.54), but there was no statistical significance in each item.Compared with patients with TAPSE≥5mm, the detention time and tracheal intubation time were longer than those TAPSE<5 mm, the central venous pressure and NT-pro BNP was higher than those TAPSE<5 mm( P<0.05), the difference was statistically significant, other indicators had no significant difference. Conclusion:It is simple and feasible to measure TAPSE by echocardiography in children after operation with left-to-right shunt congenital heart disease.TAPSE decreased postoperatively suggested that the function of right ventricle decreased at the early stage after surgery, and with left ventricle systolic function decreased, which eventually led to the increase of NT pro-BNP, the need for higher doses of vasoactive drug support, longer tracheal intubation time and the stay time in CICU.Attention should be paid to the right heart function of children after congenital heart surgery.

Objective To explore the role of the SerpinB5 and β-catenin in occurrence and development of the primary hepatocellular carcinoma (HCC). Methods The expressions of SerpinB5 and β-catenin protein and mRNA in carcinoma tissues and paracancerous tissues of 60 patients with primary HCC were detected by immumohistochemistry and real-time quantitative reverse transcriptional polymerase chain reaction (RT-PCR) methods. Results The positive expression rate of SerpinB5 protein and SerpinB5 mRNA in carcinoma tissues were significantly lower than those in paracancerous tissues:25.0%(15/60) vs. 63.3%(38/60) and 1.12 ± 0.43 vs. 5.19 ± 0.39, and there were statistical differences (P<0.01). The positive expression rate of β-catenin protein and β-catenin mRNA in carcinoma tissues were significantly higher than those that in paracancerous tissues: 65.0%(39/60) vs. 31.7%(19/60) and 4.23 ± 0.25 vs. 1.19 ± 0.17, and there was statistical difference (P<0.01). Decreased SerpinB5 expression was associated with higher serumα-fetoprotein level, larger tumor size, poor differentiation, advanced TNM stage, capsule invasion and tumor thrombosis (P < 0.01 or 0.05). Increased β-catenin expression was associated with poor differentiation, advanced TNM stage, capsule invasion and tumor thrombosis (P < 0.01 or < 0.05). The correlation analysis result showed that SerpinB5 had negative correlation withβ-catenin (carcinoma issues:r=-0.346, P=0.001;paracancerous tissues:r=-0.258, P = 0.024). Conclusions The abnormal expression of SerpinB5 and β-catenin may contribute to the progression and biologically malignant behavior of primary HCC, and SerpinB5 and β-catenin exists synergistic effect in the occurrence and development of primary HCC.

Calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial tumor of odontogenic origin. CEOT is a benign but a locally infiltrative tumor. CEOT has two clinical variants: intraosseous (central) CEOT and extraosseous (peripheral) CEOT. The peripheral type is rare. In this paper, we report two cases of CEOT. The diagnoses of the cases were verified by histopathology. This study aims to explore the clinical and imaging appearances of CEOT and improve the understanding of the disease.
Humans ; Odontogenic Tumors ; Skin Neoplasms

Vertical root fracture (VRF) is different from odontoclasis caused by trauma or injury. VRF is defined as a complete or incomplete fracture of roots caused by long-term and persistent stimulus, such as excessive forces from mastication or occlusion, improper tooth anatomy, and tooth treatment accident. Early diagnosis of VRF is essential to prevent the absorption of alveolar bone, thereby improving prognosis. Radiographic examination is the most common and effective evaluation method for VRF. Cone beam computed tomography can provide three-dimensional information for fracture details, which are more precise than traditional periapical films. In this paper, we present the radiographic features, differential diagnosis, and new treatment techniques for VRF.
Cone-Beam Computed Tomography ; Humans ; Tooth Fractures ; Tooth Root

Calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial tumor of odontogenic origin. CEOT is a benign but a locally infiltrative tumor. CEOT has two clinical variants: intraosseous (central) CEOT and extraosseous (peripheral) CEOT. The peripheral type is rare. In this paper, we report two cases of CEOT. The diagnoses of the cases were verified by histopathology. This study aims to explore the clinical and imaging appearances of CEOT and improve the understanding of the disease.

OBJECTIVETo assess the clinical and imaging features of cementoblastoma for diagnosis and differential diagnosis.

METHODSClinical and imaging data of 14 cases were selected for this retrospective study.

RESULTSA total of 14 cases of cementoblastoma patients with ages at diagnosis ranging from 11 years to 58 years (mean age, 27.6 years; median age, 21.0 years). The tumor affected 7 patients from each gender. The mandible was the main site of occurrence. The most common complaints were swelling and pain. Radiographic results showed that cementoblastoma typically presented as a well-circumscribed and radiopaque mass confluent with the involved tooth root and surrounded by a thin and uniform radio-lucent border. Tumor parenchyma was generally mixed-density, which could be divided into two types, namely, homogeneous and heterogeneous patterns. Other significant imaging features included the periphery bone of the lesion sclerosis and cortical thickening of the lower edge of the mandible.

CONCLUSIONObvious characteristics are found in the clinical and imaging findings of cementoblastoma. Accurate recognition of this lesion is significant in clinic to avoid misdiagnoses.

Adolescent ; Adult ; Cementoma ; Child ; Diagnosis, Differential ; Humans ; Mandible ; Middle Aged ; Pain ; Retrospective Studies ; Tooth Root ; Young Adult

The keratocystic odontogenic tumor (KCOT) is a common cystic lesions of jaw, which has a high recurrence rate but rarely undergo malignant transformation. This study reported a patient with primary intraosseous squamous cell carcinoma developed from KCOT.
Carcinoma, Squamous Cell ; etiology ; Cell Transformation, Neoplastic ; Humans ; Odontogenic Tumors ; complications

Objective??To?assess?the?clinical?and?imaging?features?of?cementoblastoma?for?diagnosis?and?differential?diagnosis. Methods??Clinical?and?imaging?data?of?14?cases?were?selected?for?this?retrospective?study.?Results??A?total?of?14?cases?of?cementoblastoma?patients?with?ages?at?diagnosis?ranging?from?11?years?to?58?years?(mean?age,?27.6?years;?median?age,?21.0?years).?The?tumor?affected?7?patients?from?each?gender.?The?mandible?was?the?main?site?of?occurrence.?The?most?common?complaints?were?swelling?and?pain.?Radiographic?results?showed?that?cementoblastoma?typically?presented?as?a?well-circumscribed?and?radiopaque?mass?confluent?with?the?involved?tooth?root?and?surrounded?by?a?thin?and?uniform?radio-lucent?border.?Tumor?parenchyma?was?generally?mixed-density,?which?could?be?divided?into?two?types,?namely,?homogeneous?and?heterogeneous?patterns.?Other?significant?imaging?features?included?the?periphery?bone?of?the?lesion?sclerosis?and?cortical?thickening?of?the?lower?edge?of?the?mandible.?Conclusion??Obvious?characteristics?are?found?in?the?clinical?and?imaging?findings?of?cementoblastoma.?Accurate?recognition?of?this?lesion?is?significant?in?clinic?to?avoid?misdiagnoses.

OBJECTIVETo summarize and analyze the cone-beam CT (CBCT) imaging features of ameloblastomas for clinical preoperative diagnosis.

METHODSThirty-seven cases with complete data proven by pathology were retrospectively studied for distinct CBCT features.

RESULTSOf the 37 cases, 31 were primary and 6 were recurrent. On CBCT images, the 37 cases were composed of 36 cases (97.3%) of intraosseous lesions (17 cases of multilocular lesions, 17 cases of unilocular lesions, and 2 cases of honeycomb lesion) and 1 case (2.7%) of extraosseous lesion (soft tissue lesion). Of the 17 multilocular cases, 15 (88.2%) showed tongue-shaped crests in lesions. Thirty-four cases (94.4%) showed apparent expansible change toward lip/buccal and (or) palatal/lingual sides ofjaw, with partialcortical erosion.

CONCLUSIONCBCT imaging yields accurate three-dimensional images of lesion shape and structure. Therefore, CBCT can be usedfor the clinical diagnosis and surgical assessment of ameloblastoma.

Ameloblastoma ; Cone-Beam Computed Tomography ; Humans ; Jaw Neoplasms ; Retrospective Studies