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Objective To explore the effect of clinical pathway in surgical treatment for patients with mandibular fracture.Methods 80 patients with mandibular fracture were randomly divided into the conventional therapy group(the control group) (n =40） and the clinical pathway therapy group (CP group) (n =40).The hospitalization time,medical expenses,satisfaction for the treatment,health awareness,and incidence of complications were compared between two groups.Results The results of hospitalization time,medical expenses,satisfaction for the treatment,and health awareness of the CP group were (11.86 ± 3.05) d,(9 115.43 ± 1 689.84) yuan,(91.19 ± 1.02) ％,(95.18 ±4.11)points,respectively,which were significantly better than those of the control group [(17.53 ± 2.98)d,(12 066.75 ±2 513.22)yuan,(89.39 ±1.35)％,(82.83 ± 6.56) points] (t =8.41,6.16,6.73,10.01,all P ＜0.05).The complication rate of the two groups was 2.5％,7.5％,respectively,which had no significant differences (χ2 =0.26,P ＞ 0.05).Concltsion The clinical pathway for mandibular fracture surgery is worthy of promotion.
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A growing number of reported cases of jaw osteonecrosis in patients receiving bisphosphonate have been published in the last several years. The clinical features of this condition include pain, paresthesia, bone exposure and fistula. Risk factors have been recognized and classified as local and/or systemic. Objective: The aim of this study was to demonstrate the clinical data of the patients with osteonecrosis assisted at a single institution. Patients and Methods: A total of 42 patients presenting 49 areas of jaw osteonecrosis were evaluated. Medical records were analyzed in order to collect information on underlying disease, bisphosphonate information, clinical features related to bisphosphonate-induced osteonecrosis of the jaw, as well as precipitating events related to its occurrence. Results: Most patients were female (71%) and the mean age was 64.7 years old. Breast cancer was the most frequent underlying disease (40.5%) followed by multiple myeloma, prostate cancer, lung and osteoporosis. In addition, the average use of bisphosphonate was 36.8 months and most patients had received zoledronic acid. The posterior region of the mandible was the main affected site. Among the possible triggering factors, exodontias was associated with 73.8% of the cases. The treatment modalities consisted of surgical, local irrigation with clorexidin and antibiotics and a majority of cases presented complete or partial remission. Conclusion: Most cases of jaw osteonecrosis were related to tooth extraction and surgical interventions showed a good control of the osteonecrosis cases.
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Humans , Bone Diseases, Metabolic/therapy , OsteonecrosisABSTRACT
Objective To evaluate the clinical feature of malignant ameloblastoma. Methods A review of 25 cases of malignant ameloblastoma was presented with respect to age, sex, primary site and times of recurrence, site and time of metastasis, results of follow up, pathological type. Results Male patients outnumbered female patients by 1.5 to1. The median age at which the primary tumor was first treated was 30.5 years. The primary sites were mandible(17), maxilla(5), tibia(1), rib(1), ulna(1). The most metastases were found in lung(80%), with cervical lymph nodes and liver each representing 24% and 12% of the metastatic sites. Other sites of metastasis included brain(1), femur(1), thoracic spine(1), spleen(1), myocardial(1), mediastinum(1). The median times of primary recurrence was 2.5 times. The median survival time after metastasis was 2 years. There were four pathological types which were follicular type(4), plexiform type(2), acanthomatous type(1), granular type(1). Conclusins Multiple recurrences developed in most of the 25 patients. The time between diagnosis of primary tumor and appearance of metastasis in 25 patients was long. The most frequent sites of metastasis was lung and cervical lymph nodes. Early adequate resection of the primary tumor to avoid repeated surgical intervention is advocated to prevent tumor spread.
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Objective Developmental mandibular asymmetry is a common deformity in the human craniofacial skeleton and the treatment is not easy to get satisfactory results. A retrospective study was performed to investigate the clinical results and stability after treatment of developmental mandibular asymmetry by using combination of orthognathic surgery with orthodontics. Methods 58 cases of developmental mandibular asymmetry were treated by preoperative orthodontics-orthognathic surgery -postoperative orthodontics procedure. 82 times of operation, such as mandibular osteotomy, bimaxillary osteotomy, jaw plastic surgery, genioplasty, and distraction osteogenesis were performed according to different type of asymmetry. The facial appearance and occlusion relationship were evaluated with 1～4 years of follow-up. Results Satisfactory results were achieved in 53 cases (91.4 %). Primary satisfactory results were obtained in 4 cases (6.9 %). 1 case (1.7 %) with unsatisfactory result obtained aesthetic effect and ideal occlusion after operation again. Conclusions It is essential to use both of orthodontics and orthognathic surgery in order to ameliorate facial appearance, resume occlusal function, achieve good corrective result and prevent the recurrence of the developmental mandibular asymmetry.
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medial distal wall. The root canal length of central and lateral incisors were (12.96?6.46) mm and (11.47?6.32) mm respectively. The double root canal was found in 35.9 % of central incisors and in 27.5% of lateral incisors. Most mandibular incisors with long concavity had single root canal. Conclusion: The root canal wall of mandibular incisors was thinner in medial and distal wall than in lingual and labial wall. Mandibular incisors have higher rate in double root canal and the long concavity is not significantly related with number of root canal.
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An experimental study of vascularized and nonvascularized free bone-grafts for mandibular defects in dogs was conducted.The different bone healing process was observed by histological study.The results show that with 3 cm-length bone graft either vascularized or nonvascularized its healing process is similar.Both bones of donor and receptor have osteogenic activity.This process is similar to that of fracture healing.