Parotid CT imaging reporting and data system: A preliminary study / 北京大学学报(医学版)

OBJECTIVE@#To establish a Parotid Imaging Reporting and Data System (PI-RADS) for CT diagnosis of the parotid gland neoplasms and to investigate the clinical applicable value and feasibility of PI-RADS.@*METHODS@#Patients who had been diagnosed with primary parotid gland neoplasms and had received surgical treatments in Peking University School and Hospital of Stomatology during the period of January 2013 to December 2016 were included in this study. The diagnoses were confirmed by the postoperative pathological examinations in all the patients. The CT imaging data of all patients were retrospectively reviewed and analyzed by two readers in consensus. Imaging characteristics related to the parotid neoplasms were extracted and quantified. Based on comprehensive analysis of the imaging characteristics, the probabilities of the benign and malignant neoplasms were evaluated and classified into six grades, PI-RADS 1-6 (PI-RADS 1: normal parotid gland; PI-RADS 2: confidently benign lesions; PI-RADS 3: probably benign lesions without confirmed evidence of malignancy; PI-RADS 4: suspected malignancy without sufficient evidence of malignancy; PI-RADS 5: confidently malignant lesions; PI-RADS 6: lesions with confirmed pathological evidence of malignancy).@*RESULTS@#A total of 897 patients with 1 003 parotid lesions were included. The lesions included 905 benign and 98 malignant lesions. The proportions of the malignancies in PI-RADS 2, PI-RADS 3, PI-RADS 4 and PI-RADS 5 according to the two readers in consensus were 0.4%, 5.7%, 35.5% and 96.7% respectively. The overall Cohen's Kappa test showed medium consistency between the two independent researchers (κ=0.614, P<0.001, 95%CI: 0.569-0.695). Pearson Chi-square test showed that the proportions of malignancies increased with the diagnostic PI-RADS grades (Cochran-Armitage trend test, Z=-15.579, P<0.001). The results of Pearson Chi-square tests showed significant differences between the grades [PI-RADS 2 and 3 (χ²=12.048, P=0.001); PI-RADS 3 and 4 (χ²=75.231, P<0.001); PI-RADS 4 and 5 (χ²=32.266, P<0.001)].@*CONCLUSION@#PI-RADS can be used to evaluate the risk of malignancy and will be helpful to improve the imaging diagnosis and clinical treatment of parotid gland neoplasms.

Computed tomographic features of desmoplastic ameloblastoma of the jaw / 北京大学学报(医学版)

OBJECTIVE@#To retrospectively analyze the clinical and CT imaging features of desmoplastic ameloblastomas (DA) in comparison with other types of ameloblastomas.@*METHODS@#Patients diagnosed with ameloblastoma histopathologically in Peking University School and Hospital of Stomatology from July 2000 to August 2017 were reviewed to analyze the constituent ratios and characteristics of DA. CT imaging features of DA (28 cases) were investigated in comparison with consecutive cases of solid/multicystic and unicystic ameloblastomas. The following imaging perspectives were analyzed: the border, internal structure, three-dimensional shape, tooth, the periodontium, the cortex and the expansion of the tumors. CT values were measured in the region of interest for quantitative analysis.@*RESULTS@#Among the 1 269 cases of ameloblastomas, 50 (3.9%) were DA, which showed predilections for males (74.0%). The average age of DA was about 43.9 years old, which was higher than the other two types. The anterior incisorcanine region (62.0%) and premolar region (30.0%) were most frequently affected. The incidence rate of DA in mandibule was 56.0% (28/50), which was slightly higher than that of maxilla (44.0%). The DA characteristically showed scallop border and honeycomblike or soapbubble internal structure with bone formation on CT. The mean ratios of height to mesiodistal and buccal-lingual to mesio-distal distances were 0.76 and 0.63, which were higher than the other two types. According to the degree of internal bone formation, three subtypes of DA could be observed: densely ossifying type (I), honeycomb/soap bubble type (II) and sparsely ossifying type (III). The means and standard deviations of CT values of DA were significantly higher than those of the other two types, which were (488.8±164.0) HU (type I), (171.7±102.8) HU (type II), (42.1±8.8) HU (type III).@*CONCLUSION@#CT is helpful for diagnosis of DA, which shows as solid tumor with varying degrees of internal ossification.

Association between ADAMTS14 gene polymorphism and the temporomandibular joint osteoarthritis in Chinese Han females / 北京大学学报(医学版)

OBJECTIVE@#To investigate the association between single nucleotide polymorphisms (SNP) of ADAMTS14 gene rs4747096 and osteoarthritis of the temporomandibular joint in Chinese Han females.@*METHODS@#As a case-control study, a total of 213 Chinese Han females were involved in the present study, which contained 103 temporomandibular joint osteoarthritis patients and 110 healthy people who had no symptoms or signs of temporomandibular joint osteoarthritis as control. Peripheral blood samples were collected from each participant. Genomic DNAs of temporomandibular joint osteoarthritis patients and healthy control were extracted from peripheral venous blood, which were stored in -80 °C refrigerator by using DNA extraction kits. The designed primers were used for polymerase chain reaction (PCR) amplification of specific DNA fragments. Genotype was determined by sequencing the PCR products. The software Chromas 2.22 was used to analyze the genotype. The genotype distributions, allele frequencies and genetic models between the patients and controls were compared. The age distribution was checked by t-test. Genotype and allele frequency were detected by Chi-square test.@*RESULTS@#In the present study, there were no significant differences between the osteoarthritis patients and healthy controls in terms of age. The genotype distribution was in accordance with Hardy-Weinberg equilibrium in the two groups. The genotype frequency of the ADAMTS14 (rs4747096) in the experimental group was 38.8% (AA), 55.4% (AG), and 5.8% (GG), respectively. The genotype frequency in the control group was 40.9% (AA), 43.6% (AG), and 15.5% (GG), respectively. The difference of genotype frequency of the ADAMTS14 (rs4747096) was significant between the experimental group and the control group (P=0.047). There was no significant difference in allele frequency between the two groups (P=0.415). AA and AG genotypes significantly increased the risk of the disease compared with GG in dominant model (OR=1.114, 95% CI: 1.015-1.223, P=0.028).@*CONCLUSION@#A significant correlationship was found between the ADAMTS14 (rs4747096) SNP and the temporomandibular joint osteoarthritis in Chinese Han females. The distribution of rs4747096 may be different between temporomandibular joint osteoarthritis and healthy population.

Cerebral activation during unilateral clenching in patients with temporomandibular joint synovitis and biting pain: an functional magnetic resonance imaging study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Functional magnetic resonance is a non-invasive method that can examine brain activity and has been widely used in various fields including jaw movement and pain processing. Temporomandibular disorder (TMD) is one of the most frequent facial pain problems. The objective of this study was to investigate the brain activities using functional magnetic resonance imaging (fMRI) during unilateral maximal voluntary clenching tasks in the TMD synovitis patients with biting pain.</p><p><b>METHODS</b>Fourteen TMD synovitis patients with unilateral biting pain and 14 controls were included in the study. Contralateral biting pain was defined as right molar clenching causing left temporomandibular joint (TMJ) pain. Ipsilateral biting pain was defined as right molar clenching causing right TMJ pain. Symptom Check List-90 (SCL-90) was administered to the patients and controls. Independent sample t-test was used to compare the SCL-90 subscales between the two groups. Unilateral clenching tasks were performed by the patients and controls. Imaging data were analyzed using SPM99.</p><p><b>RESULTS</b>Patients were divided into contralateral TMD biting pain group (n = 8) and ipsilateral TMD biting pain group (n = 6). The SCL-90 subscales were significantly different between the two groups for somatization, depression, anxiety, phobic anxiety, and paranoid ideation. Group analysis of the controls demonstrated brain activations in the inferior frontal gyrus, precentral gyrus, middle frontal gyrus, superior temporal gyrus, and insular. The areas of activation were different between right and left clenching task. In TMJ synovitis patients with contralateral or ipsilateral biting pain, the group analysis showed activations in the inferior frontal gyrus, superior temporal gyrus, medium frontal gyrus, precentral gyrus, and anterior cingulate cortex.</p><p><b>CONCLUSIONS</b>The inferior frontal gyrus and precentral gyrus play essential roles during the unilateral clenching task. Activation of anterior cingulate cortex in the synovitis patients with biting pain was associated with higher levels of psychological distress.</p>

Pilot clinical study of the dental cone beam CT examination before the impacted mandibular third molar extraction / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic accuracy of the cone beam computed tomography (CBCT) in judging the relationship between the impacted mandibular third molar (IMTM) and the inferior alveolar canal (IAC).</p><p><b>METHODS</b>Sixty IMTM superimposing on the canal partially or touching the canal in line on panoramic radiograms were examined by CBCT. All CBCT images of these cases were observed by two dentists respectively. Then, all these IMTM were extracted by minimally invasive surgery, and the conditions of the IMTM sockets were observed. Two dentists observed the CBCT images independently and reached a consensus. Diagnosis test was performed in this study.</p><p><b>RESULTS</b>Eight IMTM sockets were bleeding during the extracted operation, and whether the IAC wall was broken could not be judged. The other 52 IMTM sockets were clear and the walls of IAC were broken in 29 IMTM extractions. The sensitivity, specificity, Youden index, positive predictive value and negative predictive value of CBCT were 82.8%, 87.0%, 88.9% and 80.0% respectively. The diagnostic accuracy judged by the two dentists and Kappa coefficient were calculated as 84.6% and 0.800.</p><p><b>CONCLUSIONS</b>The CBCT examination had good authenticity and reliability, and it was very helpful in predicting the actual relationship between the IMTM and IAC.</p>

Comparative dosimetry of dental cone-beam computed tomography and multi-slice computed tomography for oral and maxillofacial radiology / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare the effective radiation dose levels of cone beam computed tomography (CBCT) with those of multi-slice computed tomography (MSCT) when scanning the same maxillofacial regions.</p><p><b>METHODS</b>The effective doses of 2 CBCT (NewTom 9000 and DCT Pro) and 1 MSCT (bright speed edge select 8 slice) scanners were calculated using thermoluminescent dosimeters (TLD) that were placed in a head and neck phantom, and expressed according to the International Commission on Radiation Protection (ICRP) 2007 guidelines.</p><p><b>RESULTS</b>Effective dose values ranged from 41.8 to 249.1 µSv for CBCT. The doses of MSCT scanning for maxilla, mandible and maxilla + mandible were 506.7, 829.9 and 1066.1 µSv, respectively. Dose levels of scanning only for maxilla or mandible were significantly lower than those for maxilla + mandible.</p><p><b>CONCLUSIONS</b>When scanning the same maxillofacial regions, the dose levels for NewTom 9000 and DCT Pro CBCT images were lower than those for Bright speed edge select 8 slice MSCT images. Dose levels reduction could be obtained when smaller regions were scanned.</p>

Radiographic study on joint space changes of patients with anterior disc displacement of temporomandibular disorders / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To compare the temporomandibular joint space and condylar position on transcranial projections between the patients with anterior disc displacement (ADD) and the healthy controls. To investigate the diagnostic value of the condylar position for the ADD patients.</p><p><b>METHODS</b>120 joints of 120 ADD patients and 30 joints of healthy adults, who were taken transcranial projections, were included in this study. The transcranial projections were scanned with precise scanning apparatus and saved as joint photographic group image. The joint spaces were measured with the software of Auto CAD. Two different quantitative methods of joint space measurement, ZHANG Zhen-kang's method and Kamelchuk's method, were used based on the transcranial projections. The ln(P/A) values were calculated (P:width of the posterior joint space; A: width of the anterior joint space). Concentric position of the condyle was defined if ln(P/A) value was between -0.25 and +0.25. If ln(P/A) was larger than +0.25, the condylar position was defined as anteriorly eccentric. Posteriorly eccentric position was indicated when ln(P/A) value was lower than -0.25. The results were compared and software SPSS 12.0 was used for statistical analysis.</p><p><b>RESULTS</b>The results of the two linear measurement methods demonstrated that the superior and posterior joint spaces of the ADD patients were narrower than those of the healthy controls significantly (P < 0.05), while the anterior joint spaces of the ADD patients had no significant differences with those of the controls (P > 0.05). In addition, there were significant differences in ln(P/A) values of joint spaces between the patients with ADD patients and the controls (P < 0.05).</p><p><b>CONCLUSION</b>Posterior position of the condyle could be a sign of existence of ADD, but ADD could not be diagnosed only by the posterior condyle position showed on the transcranial projections because of the variation of the condylar position.</p>

Relationship between the impacted mandibular third molar and the mandibular canal on panoramic radiograph and cone beam computed tomography / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the actual relationship between the impacted mandibular third molars (IMTM) and the mandibular canals on panoramic radiographs and cone beam computed tomography (CBCT).</p><p><b>METHODS</b>A cross-sectional study design was used and panoramic radiographs of 390 patients (645 sides developed IMTM) were included in the present study. The relationship between the IMTM and the mandibular canal on panoramic radiographs was defined in three types: 'untouched', 'touching in point', and 'superimposition or line touching'. The IMTM superimposing and line touching with mandibular canals on panoramic radiographs were examined by CBCT.</p><p><b>RESULTS</b>The relationship types on panoramic radiographs were as follows: 'untouched' type 441 IMTM (68.4%), the type of 'touching in point' 149 IMTM (23.1%) and the type of 'superimposition and line touching' 55 IMTM (8.5%). CBCT showed that 25 (50%) of 50 IMTM of superimposition and line touching type impinged on the mandibular canals.</p><p><b>CONCLUSIONS</b>More than 90% of IMTM which do not have intimate relationship with the mandibular canals can be screened out by panoramic radiographs. The IMTM which belong to the line touching and superposition type on panoramic radiographs should be examined by CBCT.</p>

Fistulectomy as a surgical option for pulmonary arteriovenous malformation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Surgical resection remains the treatment of choice for pulmonary arteriovenous malformation but removes some normal lung parenchyma. This study aimed to evaluate the effect and safety of the lung-saving procedure of fistulectomy as an alternative to lung resection.</p><p><b>METHODS</b>From July 2003 to July 2008, 6 selected patients with pulmonary arteriovenous malformations underwent fistulectomies. Among them, 1 patient underwent emergency operation and 2 underwent bilateral operations. One patient received postoperative embolotherapy.</p><p><b>RESULTS</b>No hospital deaths or postoperative morbidity occurred. PaO2 increased significantly after operation. All patients were free of symptoms and hypoxia during a follow-up for 9 months to 5 years.</p><p><b>CONCLUSIONS</b>Fistulectomy is a safe and effective procedure for patients with pulmonary arteriovenous malformation and may be an alternative to lung resection.</p>

Effect of radiation on the activity and expression of Ca(2+)-Mg(2+)-ATPase in rat masseter muscle / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the activity and expression of Ca(2+)-Mg(2+)-ATPase in irradiated rat masseter muscle.</p><p><b>METHODS</b>The rats were irradiated locally with a single dose of 20 Gy X-ray. The activities of Ca(2+)-Mg(2+)-ATPase were measured with colorimetric method. The protein expression of Ca(2+)-Mg(2+)-ATPase was determined by Western blotting and immunohistochemistry.</p><p><b>RESULTS</b>The activities of Ca(2+)-Mg(2+)-ATPase in masseter muscle decreased by approximately 20% and 40% in irradiated rats on days 3 and 30 postirradiation. There was significant difference in the expression of Ca(2+)-Mg(2+)-ATPase protein between irradiated and nonirradiated rats on day 30 postirradiation. Ca(2+)-Mg(2+)-ATPase protein was found in the cytoplasm of masseter muscle.</p><p><b>CONCLUSIONS</b>The decrease of ATPase activity played an important role in the cause of radiation-induced skeletal muscle injury, while there was no significant reduction in the expression of Ca(2+)-Mg(2+)-ATPase protein in irradiated rat masseter muscle.</p>

Investigation on disc position of the temporomandibular joint in asymptomatic volunteers by magnetic resonance imaging / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the types of disc position of the temporomandibular joint (TMJ) and their relationship with age and gender in asymptomatic volunteers by magnetic resonance imaging (MRI).</p><p><b>METHODS</b>A total of 100 asymptomatic volunteers were divided into 5 groups (11-, 21-, 31-, 41-, 51 - 60 years old), 10 male and 10 female were included in each group. A total of 200 TMJs were scanned with Siemens Trio Tim 3.0T MRI system oblique-sagittally at closed- and open-mouth positions. Visual evaluation of MR images were performed on 3 neighbour slices of each TMJ (lateral, central, medial).</p><p><b>RESULTS</b>There was a normal disc-condyle relationship in 59 of the 100 asymptomatic subjects. The normal disc position, anterior disc displacement and insidious anterior disc displacement (IADD) were observed in 140 (70.0%), 14(7.0%) and 46(23.0%)joints respectively, which showed no significant differences among different age groups or between genders (P > 0.05). The maximum mouth opening of the 100 asymptomatic volunteers was (46.3 +/- 5.5) mm, with no significant difference among the various types of disc position (P > 0.05).</p><p><b>CONCLUSIONS</b>Disc displacement does exist in the asymptomatic volunteers, however, its occurrence is not associated with age and gender. IADD is the main type of the disc displacement in asymptomatic volunteers. There is no close relationship between the imaging manifestation of the disc displacement and clinical symptoms.</p>

A study of trabecular bone structure in the mandibular condyle of healthy young people by cone beam computed tomography / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility of cone beam computed tomography (CBCT) for the evaluation of trabecular bone structure in mandibular condyle and to investigate the distribution of the trabecular bone structure within mandibular condyle.</p><p><b>METHODS</b>Eighty condyles from 40 healthy young volunteers (aged 20-32) were scanned by CBCT. A coronoid image was acquired of each condyle and divided into 8 regions where regions of interest were specified. After CBCT images were binarized, four morphological parameters including bone volume fraction, trabecular thickness, trabecular number and trabecular separation were computed.</p><p><b>RESULTS</b>All parameters were significantly different between the superior zone and middle/inferior zone of the condyle (P < 0.05). Superior zone showed the largest bone volume fraction (52.2%), the highest trabecular number (1.33 mm(-1)), the thinnest trabecular thickness (393.48 microm), and the smallest trabecular separation (361.59 microm). Inferior zone showed the smallest bone volume fraction (49.64%). These results were not significantly different between bilateral sides of the condyles (P > 0.05).</p><p><b>CONCLUSIONS</b>Trabecular bone structure was inhomogeneous within the condyle, but symmetrical between bilateral sides of the condyles. CBCT combined with image processing is a feasible tool in evaluating trabecular bone structure of human mandibular condyle.</p>

Cone beam computed tomography in the diagnosis of temporomandibular joint osteoarthrosis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical use of cone beam dental CT in the diagnosis of temporomandibular joint osteoarthrosis.</p><p><b>METHODS</b>Forty-eight cases diagnosed as temporomandibular joint osteoarthrosis (OA) and disk displacement with or without reduction accompanied by OA changes were included, and a total of 96 joints received both trans-pharyngeal radiography and cone beam CT (CBCT) examination. The detectable rate for OA radiographic changes was compared between the two examinations.</p><p><b>RESULTS</b>The radiographic appearances of osteoarthrotic condyle included six types: loss of the lamina dura density of condyle surface (type I), destructive and erosive bone changes (type II), flattening of the articular surface (type III), sclerosis (type IV), osteophytes (type V), and false cyst change (type VI). The detectable ratio of CBCT for all types of osteoarthrosis was 65.63%, 37.50%, 27.08%, 31.25%, 28.13%, 1.04%, respectively, and the detectable ratio of trans-pharyngeal radiographs was 52.08%, 19.79%, 32.29%, 23.96%, 12.50%, 2.08% respectively. Intraobserver and interobserver reproducibility for type I and type II was in good agreement with both the trans-pharyngeal radiographs and CBCT, Kappa > 0.60.</p><p><b>CONCLUSIONS</b>CBCT had higher detectable rates for pathological changes of osteoarthrosis, and could show the exact location, size, and the types of pathological changes. CBCT may be used as a measure in evaluating disease severity and progression, and in clinical trials of disease treatment.</p>

Aquaporin-1 and aquaporin-3 expressions in the temporo-mandibular joint condylar cartilage after an experimentally induced osteoarthritis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Over 70% of the total tissue weight in the cartilage matrix consists of water, and the early-stage osteoarthritic cartilage is characterized by swelling. Water transport in the cartilage matrix and across the membranes of chondrocytes may be important in normal and pathological conditions of cartilage. The purpose of this study was to identify aquaporin-1 (AQP1) and aquaporin-3 (AQP3) expressions in the mandibular condylar cartilage after experimentally induced osteoarthritis (OA) in rats.</p><p><b>METHODS</b>An experimental temporomandibular joint OA was induced by partial discectomy in rats. The pathological characteristics of the normal, early-stage, and late-stage osteoarthritic TMJ cartilages were verified by histological techniques. The AQP1 and AQP3 gene expressions in the normal and osteoarthritic cartilages were measured using quantitative real-time reverse-transcription PCR analysis. The cartilage sections were incubated in primary polyclonal antibodies to AQP3; immunofluorescent microscopy was used to examine the AQP3 expression shown by its protein level.</p><p><b>RESULTS</b>The mRNA expression levels of AQP1 and AQP3, analyzed using quantitative PCR, revealed that AQP3 mRNA was highly up-regulated in the OA cartilage, which was considered significant. There was no notable difference in the expression of AQP1 mRNA between OA and normal controls. With the progressing of the OA, the localization of the AQP3 protein was quite different from that of the normal cartilage. Compared to the normal cartilage, the expressions of AQP3 protein were observed mainly in the proliferative zone and the upper mid-zone chondrocytes at the early-stage of OA, and were observed to appear frequently throughout the mid- and deep zone during the late-stage of OA.</p><p><b>CONCLUSIONS</b>The high expression of AQP3 mRNA in the OA cartilage and the different localization of the AQP3 protein suggest that it may play a particular role in OA pathogenesis. Further study of AQP3 function may provide new insight into the understanding of the molecular mechanisms underlying OA.</p>

Study on differential estrogen receptor beta expression of mandibular condylar chondrocyte in temporomandibular joint osteoarthritis / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To test the differential Estrogen Receptor (ER) beta levels of mitochondrial proteome of mandibular condylar chondrocyte in the rat model of temporomandibular joints osteoarthritis (TMJOA).</p><p><b>METHODS</b>25 SD rats were divided into experimental group (15 rats) and control group (10 rats) randomly. TMJOA models were created in left sides of TMJ of 15 SD rats by the partial resection of the articular disc. The experimental rats were killed 3 months after operation. After the chondrocytes culture, Immunohistochemistry, semiquantitative RT-PCR and Western blot were used to test the differential ER beta expression levels in mitochondrial proteome of mandibular condylar chondrocytes. Mitochondrial proteins identification was carried out by two-dimensional electrophoresis and peptide mass fingerprint (PMF).</p><p><b>RESULTS</b>PMF showed that one of the differential proteins was ERP. Immunohistochemistry and Western blot results suggested the significant difference of ERbeta protein levels between operation-treated and control group. The operation-treated group had lower ERbeta levels (P < 0.01).</p><p><b>CONCLUSION</b>It has been demonstrated that ERbeta protein levels were decreased in mitochondria of TMJOA mandibular condylar chondrocytes, which suggests a role for mitochondrial ERbeta in the effects on TMJOA. The pathological role of ERbeta in the regulation of TMJOA progress remains to be elucidated.</p>

Posttraumatic temporomandibular joint ankylosis: clinical development and surgical management / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the patterns of condylar fractures associated with temporomandibular joint ankylosis (TMJA) and treatment methods and results based on the different types of ankylosis.</p><p><b>METHODS</b>Forty-two joints of ankylosis in 31 patients with were categorized to four groups according to Sawhney's classification and undergone surgical treatment as follows: a joint release and disc reposition for Type I ankylosis, a dissection of bony block and disc reposition for Type II; a dissection of full-joint and employment of the temporal myofascial flap as interposition for Type III; a radically dissection of full joint followed by ramus distraction osteogenesis and genioplasty for Type IV. All of patients were followed up for 9 to 54 months with an average of 30 months. The range of mouth opening and temporomandibular joint (TMJ) function were assessed. Condylar fractures were retrospectively investigated on the patterns and the course of ankylosis development. Macroscopical visualization on the osseously ankylosed sites and disc displacement were analyzed in comparison with the radiological findings.</p><p><b>RESULTS</b>Condylar sagittal and comminuted fractures were most susceptible to TMJA. Early fibrous ankylosis occurred usually at the 4th or 5th month post-traumatically with an average month opening of 18.3 mm. The articular discs were found displaced in all cases and early bony bridge formed at a limited area where there was no disc as cushion. During fellow-up, considerable improvement in mandibular movement was attained with a stable joint function and mouth opening range of over 30 mm except for two cases in which ankylosis relapsed.</p><p><b>CONCLUSIONS</b>Condylar sagittal and comminuted fractures are most likely to cause ankylosis. Early surgical intervention could reduce the disc and avoid the later ankylosis.</p>

Temporomandibular disorders related pain interaction with age, sex and imaging changes of osteoarthrosis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the relationship of temporomandibular disorders (TMD) related pain with age, sex and imaging changes of osteoarthrosis (OA).</p><p><b>METHODS</b>All the patients were grouped based on age, sex, imaging changes of OA and TMD related pain. Craniomandibular index (CMI) was calculated for all the patients.</p><p><b>RESULTS</b>TMD related pain was common in females. Significant differences of CMI were existed in all groups under the age of 45 years old. The occurrence of imagine changes of OA was higher in females than in males (P < 0.001).</p><p><b>CONCLUSIONS</b>TMD related pain and imaging changes of OA were more common in females, especially in 16 - 30 years old females.</p>

Brain activities during maximum voluntary clenching with and without soft splint in patients with hemimasticatory spasms by functional magnetic resonance imaging / 中华口腔医学杂志

<p><b>OBJECTIVE</b>Functional magnetic resonance imaging (fMRI) was used to detect the cerebral cortical somatotopy during maximum voluntary clenching with and without soft splint in patients with hemimasticatory spasms (HMS) and the central mechanisms of HMS and the rule of the splint therapy.</p><p><b>METHODS</b>Four HMS patients were selected and the spasms sides were right in two cases and left in the other two cases. FMRI images were obtained on Elscint/GE 2.0 Tesla MR system. Block design was used and the movement pattern was the onset of spasms after maximum voluntary clenching with and without soft splint. The fMRI data were analyzed by SPM99 software.</p><p><b>RESULTS</b>With the onset of spasms after maximum voluntary clenching, the activation of motor cortex in 3 HMS patients was found lateral dominance on the left side, and the other one showed bilateral activation. All the 4 patients were found activation in cingulate area. With the onset of spasms after maximum clenching wearing soft splints, the activation of motor cortex showed no lateral dominance on the left side, and 3 patients were not found activation in cingulate area.</p><p><b>CONCLUSIONS</b>The changes of the activation in motor cortex and cingulate area during the onset of spasms after clenching with and without soft splint might be the central mechanisms of the rule of splint therapy, through which the soft splint might function in alleviating muscle pain.</p>

A preliminary study of angiographic classification and treatment of central arteriovenous malformations in jaws / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To elaborate on the angiographic classification of central arteriovenous malformations (AVMs) in jaws, and to evaluate the correlation between this classification and treatment options.</p><p><b>METHODS</b>X-ray films and angiograms of 25 cases with AVMs in the jaw were retrospectively reviewed to evaluate the appearance of radiolucency, feeding arteries, nidus of the malformations and draining veins. Based on the findings a classification of angioarchitecture was recommended. Furthermore, the treatment results of these cases were reviewed to assess the correlation between this classification and treatment options.</p><p><b>RESULTS</b>The angiographic pictures of 25 cases with central AVMs could be divided into five types: type I (n = 5) was with merely diffused micro-arteriovenous fistulas (AVFs); type II (n = 8) demonstrated a large venous pouch, all the feeding arteries drained into it; type III (n = 7) had a large venous pouch together with diffused micro-AVFs (I + II); type IV (n = 2) had multiple venous pouches; type V (n = 3) had multiple venous pouches and diffused micro-AVFs (I + IV). The angioarchitecture corresponded well to the radiographic appearance in all except one case. With respect to the treatment, type II, III, IV AVMs gained clinical cure in 100% of cases, whereas type I and type V AVMs obtained clinical cure only in 3 of 5 and 1 of 3 cases respectively.</p><p><b>CONCLUSIONS</b>Central AVMs in jaws exhibited variant patterns of angioarchitecture, which could be divided into five types. Elaboration of this classification was helpful for decision-making on choosing appropriate therapy.</p>

Psychological status in patients with temporomandibular disorders / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate levels of psychosocial incapacity in patients with temporomandibular disorders (TMD) by using the Symptom Checklist 90 (SCL-90).</p><p><b>METHODS</b>Three hundred and thirty-eight patients who came to the Center for TMD and Orofacial Pain of Peking University School of Stomatology, from March to September of 2004 were included in the present study. All of them were evaluated by SCL-90. The one-sample t-test and multivariate analysis of variance were performed to find the psychological difference between the normal and TMD groups.</p><p><b>RESULTS</b>(1) There was a statistically significant difference (P < 0.05) in the scores of Symptom Checklist 90 between healthy controls and TMD group, and TMD patients got higher scores on somatization, obsessive compulsive, anxiety, hostility, phobic anxiety, psychoticism. (2) Twenty-three percent of 338 TMD patients had some psychological symptoms. (3) All patients were evaluated by analysis of reliability, and the reliability coefficients was 0.958.</p><p><b>CONCLUSIONS</b>The psychological problems of TMD patients should be emphasized and SCL-90 instrument was also suitable to screen the psychological symptoms of TMD patients in China.</p>