Application of modified lateral window for maxillary sinus floor augmentation / 浙江大学学报·医学版

Objective: To evaluate the clinical efficacy of modified lateral window for maxillary sinus floor augmentation (MSFA). Methods: Fifty-five patients who visited the Stomatology Hospital Affiliated to Zhejiang University School of Medicine between June 2012 and October 2014 were enrolled in the study. Patients underwent MSFA with Bio-Oss grafts based on modified access window. During the operation the vertical height of the bony window was reduced from 6-8 mm of conventional oval window to 4-5 mm of slot-shaped window. The sinus membrane was detached completely via the lateral access and large particle Bio-Oss graft was placed in the sub-mucosal space. The implant survival, graft height, graft volume and resorption rates were measured. Intra-op and post-op complications were recorded. Results: There were 86 implants inserted. The 2-4 year cumulative survival rates were 97.67% by implant-based analysis and 96.36% by patient-based analysis. The residual bone height was (4.7±2.6) mm and bone width was (8.4±2.7) mm. The bone height of implantation site immediately after operation was (16.1±2.5) mm and it was (16.2±2.2) mm at restoration. The bone heights at 1 and 2 years after operation were (14.9±2.5) mm and (13.6±2.6) mm, respectively. The graft height was (10.6±2.8) mm and the graft volume was (1569±745) mm3 immediately after operation. The resorption rate of graft height 6 months after operation was 3.79% and that of graft volume was 7.87%. The 1-year accumulative resorption rate of graft height was 6.63% and that of graft volume was 10.89%. The 2-year accumulative resorption rate of graft height was 7.58% and that of graft volume was 15.26%. Small membrane perforation during MSFA was observed in 5 cases and all were successfully repaired by a collagen Bio-Gide membrane. Conclusion: The modified lateral technique obtains high implant survival rate, excellent graft stability and low complication rate at 2-4 year clinical follow-up, indicating that it is a safe, predictable and minimally invasive surgical method for severe atrophic maxillary posterior dentition.

Fast formation of biomimetic apatite coatings on pure porous titanium implant's surface / 生物医学工程学杂志

The aim of this study was to elaborate a dense, strong and thin calcium-phosphate coating on commercial porous pure titanium implant surface in the light of a fast biomimetic procedure. After being polished, sandblasted, cleaned and treated with the mixture of HF and HNO3, the titanium plates were divided into two groups, namely group A and group B. The specimens of group A were free from any treatment. The specimens of group B were treated with the mixture of 48% H2SO4 and 18% HCl. All specimens soaked in SBF-A solution for 1d. Then the specimens were immersed in the SBF-B solution for 2 d. A thin calcium-phosphate coating was deposited on all the specimens of the two groups, the surface consisted of well-formed crystals, which were proved to be the mixture of hydroxycarbonated apatite (HCA) and octacalcium phosphate (OCP); the coating's Ca/P rate was 1.51. A thin carbonated calcium-phosphate coating was deposited on porous pure titanium by the use of the fast biomimetic procedure.

A study on the repair of bone defects with deproteinized bone surrounded by titanium mesh and osteoblasts / 生物医学工程学杂志

To investigate the ability of composite graft of osteobalsts and deproteinized bone-titanium mesh (DPB-TM) scaffold to repair cranial bone defect. 30 rabbits were randomly divided into 3 groups. The passage 3 fetal rabbit osteoblasts were seeded into porous DPB-TM scaffolds at the density of 5 x 10(6) ml(-1) as the experimental group. The same defects were respectively reconstructed by DPB-TM or osteoblasts as the control groups. After 12 weeks, the result was evaluated by three-dimensional computed tomographic scanning, gross inspection, scanning electron microscopy, histological examination and mechanics test, respectively. In the experimental group, bone trabecula was observed to pass the defect and interface was mixed. No demarcation between the region of the bone defect and the normal bone was observed. There was plenty of new bone on the scaffold. Part of the scaffold was absorbed. In view of mechanics, the intensity of artificial bone (18.93+/-1.12 MPa) was higher than that of normal bone (16.96+/-1.60 MPa) (P<0.05). In the control groups, only fibrous tissue was observed in the defect region, there was no new bone formation. The tissue engineering bone constructed by osteoblasts and DPB-TM scaffold can be applied to the repair of bone defect.

Exam stress and salivary immunological function / 中国组织工程研究

BACKGROUND: It has been verified in relevant clinical and epidemiological researches in recent years that a part of stomatopathy is associated to psychological stress factors.OBJECTIVE: To analyze the relationship between the changes in salivary secretory IgA and cortisol and psychological stress states.DESIGN: cross-sectional investigation was designed.SETTING: Department of Stomatology, Zhejiang University.PARTICIPANTS: The investigated participants were 60 students in the 2nd grade of Fuzhou №.2 Senior School selected from May to November 2003. Fifty-seven of them accomplished the investigation, of male; aged varied from 17 to 19 years, of healthy, no stomatopathy and family history of disorders in immune system and without indulgence in smoke and alcohol. All of them had participated in the 3-day terminal exam.METHODS: Before the exam, evaluation with symptom checklist (there are 90 questions, including about 10 factors, such as somatization, compulsive state, sensitive interpersonal relationships, melancholy, anxiety, hostility, fear, paranoid state, psychotic state and others. The total average score results by divided total score with 90. ) was applied. Fifty-seven students that had accomplished the investigation were divided in low-symptom group (the total score of symptom checklist ＜ 2.0) and high-symptom group (the total score ≥ 2.0). 5 weeks before the exam, the students were called together to fill up investigation form of general situation. Four weeks before the exam and at 7: 30 am on the day of exam, the first and second saliva specimens were collected respectively to determine salivary secretory IgA and cortisol before and after exam stress. The students were called together again 3 days after exam to fill up questionnaire on psychological health to evaluate their psychological health state.stress.RESULTS: Intention management analysis was adopted, in which 57 stulist with Chinese norm: after exam, the scores of 4 factors, named compulsive state, anxiety, hostility and paranoid state, were higher than Chinese norm [(1.98±0.72, 1.69±0.61) scores; (1.79±0.31, 1.42±0.43) scores; (1.77±0.68,1.50±0.57)scores; (2.00±0.71, 1.52±0.60)scores, P ＜ 0.01] and there was parison of salivary secretory IgA content after stress: that before exam in low symptom group was remarkably higher than that in high symptom group [(236.6±82.29),(194.55±66.29) mg/L, P ＜ 0.05], that after exam in low symptom group was higher than that in high symptom group [(182.21±55.92,tration after stress: that after exam in low symptom group was remarkably higher than that in high symptom group [(5.96±2.46, 3.68±2.26) μg/L, P secretory IgA and cortisol in two groups: the decrease rate of secretory IgA (0.012±0.197) and increase rate of cortisol (0.199±0.654) were relevant to compulsive state and paranoid state.CONCLUSION: In evaluation with symptom checklist after exam, the scores of anxiety, compulsive state, hostility and paranoid state were higher than Chinese norm, indicating that exam stress induces increased anxiety level and variation of psychological behavior of students. The difference presented in decrease rate of salivary secretory IgA before and after exam stress between high and low symptom groups, explaining that the students with more psychological symptoms are weak to endure exam stress.

THE APPLICATION OF RAPID PROTOTYPING IN THE ORTHOGNATHIC SURGERY / 解剖学报

Objective To construct a geometric skull model by using three-dimensional reconstruction, computer tomography scanning and rapid prototyping technology and evaluate its significance in treatment of complex oral and maxillofacial deformities. Methods A cranial and a goldenhar syndrome patient with complex oral and maxillofacial deformities bone received continuous volumetric scanning of skull and the data acquisition was done by an electron computed tomography, by which reconstruction was performed and the obtained images saved as STL files. Then the data were input into rapid prototyping machine to make three-dimensional geometric model. Direct measurement, designation and surgery simulation could be done on this three-dimensional model. Then the mandibular mirror physical model was manufactured using rapid prototyping according to the normal side. Results A computer-aided model according to CT data could represent the three-dimensional anatomic structures and their relationships precisely. The replica exhibited dimensional errors ranging 0.02 mm to 0.53 mm. Which provided strong basis for accurate understanding of disease status and reasonable surgical plans and helped improve the curative effect of surgery. Conclusion Rapid prototyping can help surgeons in many ways for therapy of the complex oral and maxillofacial deformities.

Clinical application and histological observation of pedicled buccal fat pad grafting / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To introduce the applied anatomy of pedicled buccal fat pad (BFP) graft and a series of histological changes in the healing process of BFP as an uncovered pedicled graft.</p><p><b>METHODS</b>The healing processes of BFP are demonstrated via uncovered pedicled grafts on rabbits in histological examination. Uncovered buccal fat pads were used to repair soft tissue defects in rabbit oral cavities.</p><p><b>RESULTS</b>The uncovered buccal fat pads showed complete epithelialization of their oral surfaces at 6 to 8 weeks after surgery and were slowly replaced by fibrous tissue.</p><p><b>CONCLUSIONS</b>Advantages of the pedicled buccal fat pad graft include an anatomic region that is consistent and easy to excise. The operation can be performed in one incision, affecting neither appearance nor function of the area. Use of the buccal fat pad provides a good reconstruction of soft tissue defects in the mouth.</p>

Study on the correlation between the structure of TMJ and vertical craniofacial pattern,occlusion in ClassⅡ~1 Children / 实用口腔医学杂志

Objective:To investigate the relationship between the structure of TMJ and the craniofacial pattern,occlusion in ClassⅡ1mandibular retrusion children. Methods:TMJ MRI,lateral cephalometric were taken respectively from 30 ClassⅡ1 patients (14 boys and 16 girls,the average age was 10.8?1.1 years). The condyle position and disc position were measured. The correlation of condyle and disc position with craniofacial pattern and occlusion were analyzed metrically and compared with pearson test.Results:There were low positive correlation between MP-SN angle and anterial space. No correlation between posterior-anterior ratio and other data were found. The posterior facial height and Dp-Cc/Cs-Cc angle had low positive correlation. The anterior facial height and Dp-Cc/Cs-Cc、Ca-Ca'、Ca-Cp showed low negative correlation,and little correlation was found between condyle position and overbite and overjet. Overbite had no correlation with disc-condyle-fossa relationship. However,The positive correlation was found between the overjet. and Ca-Dm and Dp-Cc/Cs-Cc,and Pearson coefficient is 0.420 and 0.460.Conclusion:Vertical craniofacial patter has relation to forward displacement of condyle and backward displacement of disc. A deeper overjet is related with a higher risk of abnormal disc-condyle-fossa relationship.

Clinical evaluation of a radiographic film holder for standardized alignment of intraoral film / 实用口腔医学杂志

Objective:To introduce a self-made film holder for standardized alignment of intraoral film and to evaluate its validity.Methods:The film holder,consisting of film backing,bite block and indicating part,was made of a kind of transparent material.20 patients were photographed using the film holder for serial dental films and another 20 patients were photographed using conventional bitewing instrument.The distance between the cemento-enamel junction and alveolar crest and the distance between cemento-enamel junction of adjacent teeth were measured on the serial films taken in the two groups.Results:The films taken by the use of film holder showed greater reproducibility than those by bitewing.Variables changes were significant smaller in film holder group than those in bitewing group.Conclusion:The film holder can be used as a instrument for standardized alignment of intraoral film.