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Pulpitis, periodontitis, jaw bone defect, and temporomandibular joint damage are common oral and maxillofacial diseases in clinic, but traditional treatments are unable to restore the structure and function of the injured tissues. Due to their good biocompatibility, biodegradability, antioxidant effect, anti-inflammatory activity, and broad-spectrum antimicrobial property, chitosan-based hydrogels have shown broad applicable prospects in the field of oral tissue engineering. Quaternization, carboxymethylation, and sulfonation are common chemical modification strategies to improve the physicochemical properties and biological functions of chitosan-based hydrogels, while the construction of hydrogel composite systems via carrying porous microspheres or nanoparticles can achieve local sequential delivery of diverse drugs or bioactive factors, laying a solid foundation for the well-organized regeneration of defective tissues. Chemical cross-linking is commonly employed to fabricate irreversible permanent chitosan gels, and physical cross-linking enables the formation of reversible gel networks. Representing suitable scaffold biomaterials, several chitosan-based hydrogels transplanted with stem cells, growth factors or exosomes have been used in an attempt to regenerate oral soft and hard tissues. Currently, remarkable advances have been made in promoting the regeneration of pulp-dentin complex, cementum-periodontium-alveolar bone complex, jaw bone, and cartilage. However, the clinical translation of chitosan-based hydrogels still encounters multiple challenges. In future, more in vivo clinical exploration under the conditions of oral complex microenvironments should be performed, and the combined application of chitosan-based hydrogels and a variety of bioactive factors, biomaterials, and state-of-the-art biotechnologies can be pursued in order to realize multifaceted complete regeneration of oral tissue.
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Chitosan/chemistry , Tissue Engineering , Hydrogels/chemistry , Biocompatible Materials/chemistry , Cartilage , Tissue Scaffolds/chemistryABSTRACT
@#The jaw and femur are commonly used sites in basic research for modeling bone defects or inserting implants. An increasing number of studies have identified that the jaw and femur indeed show great differences in embryonic development and growth, histomorphology and bone metabolism. A literature review showed that, compared with the femur, the main osteogenic pathway of the jaw may have better osteogenic ability, and its stem cells have better proliferation and osteogenic differentiation ability. However, the jaw structure is less regular, the osteogenic differentiation ability of its osteoblasts is mineralization slightly weak, and the immune cells of the jaw are more sensitive to cytokines. These may be the reasons why the osseointegration of the jaw implant is different from that of the femur in animal experiments, but its specific mechanism has not been clarified.
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@#Marsupialization is effective in the treatment of cystic lesions of the jaw. It is a simple operation that can result in minimal trauma, the reduction of postoperative recurrence, and maximum preservation of the surrounding tissue structure and function. However, there is a certain failure rate in clinical treatment due to the improper grasp of indications and nonstandard operation. The highest failure rate reported in the literature is 32.6%. To further standardize the clinical application of marsupialization and improve the success rate of treatment, we put forward an expert consensus of marsupialization in the treatment of jaw cystic lesions by reviewing the domestic and foreign literature and summarizing the experience in marsupialization from some famous domestic experts. In this consensus, we propose three elements of marsupialization: the establishment of the opening, the maintenance of cyst plugs and regular washing. The scope of application of marsupialization includes jaw cysts and cystic ameloblastomas. It is necessary to standardize the position of the opening, the size of the opening and the manufacture of the cyst plug, and a panoramic film or cone beam computed tomography(CBCT) should be used to observe the changes in the cystic cavity before and after operation. A second-stage operation should be performed when the lesion is significantly reduced by more than 50% or at least 5 mm from important structures; furthermore, the teeth of focus should be treated according to the relationship between the lesion and tooth and the type of tooth.
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Objective:To study the expression of B-1a cells in mice with obesity and periodontal infection.Methods:Mouse models of diet induced obesity combined with experimental periodontitis were established,the expression of CD5 protein,anti-collagenⅠ antibody(anti-Col-Ⅰantibody) and IL-10 protein was examined in mouse jaw bone and spleen by immunohistochemistry and Western blot;The mRNA expression of CD5,anti-Col-Ⅰantibody and IL-10 in mouse jaw bone was detected by real time quantitative PCR.Results:The mRNA and protein expressions of CD5 and IL-10 and anti-Col-Ⅰantibody in jaw bone in periodontitis group were significantly higher than those in control group(P<0.001).The protein expressions of CD5 and IL-10 and anti-Col-Ⅰantibody in spleen in obesity group were significantly higher than those in standard group(P<0.05).The protein expression of anti-Col-Ⅰantibody in spleen in standard accompanying periodontal ligature group was significantly higher than that in standard without periodontal ligature group(P<0.05).Conclusion:B-1a cells are activated in the early stage of obesity and periodontal inflammation with a certain pathological significance and without interation between the two inflammatory states in the pathological mechanism.
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Objective:To observe the repair effect of nano hydroxyapatite/magnesium(nHA-Mg)porous composite material modified by poly lactic acid/glycolic acid copolymer(PLGA) on the jaw bone defect of rabbits,and to elucidate the mechanisms preliminary.Methods:The mandibular defect models of 10 mm×5 mm×1 mm in the 18 rabbits were established.Nine rabbits were selected and implanted with nHA-Mg composite materials modified by PLGA in the left as experimental group and the right as blank control group;the other nine were implanted with nHA-Mg in the left as positive control group and the right as blank control group.The rabbits were sacrificed at 4, 8, 12 weeks (respectively 3 of experimental group and positive control group every time)and the mandibular defect areas were intercepted and observed by imaging and histological examination;the sizes of the newborn trabecula area and residual materials in experimental group and positive control group were compared.Results:Compared with positive control group and blank control group, the percentage of newborn trabecula area of the rabbits in experimental group was increased (P0.05).The imaging results showed that the new bone formation can be observed in experimental group and better than positive control group and blank control group.The paraffin section results indicated that there were visible vascular tissue and newborn trabecula,the osteoblasts gathered around the bone trabecula;a lot of pits were located in the bone trabecula, and the pits contained osteocytes in experimental group.As the prolongation of time,thickened newborn trabecula, dense arrangement and trend of converting to lamellar bone were observed in experimental group.The hard tissue section results showed that the remaining amount of materials in experimental group was more than that in positive control group.Conclusion:nHA-Mg porous composite materials modified by PLGA can effectively reduce the rate of degradation in the body, promote osteogenesis and guide the bone regeneration.
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Objective:To study the value of 3D print technique in the reconstruction of the defects and malformations of oral and maxillofacial bone.Methods:6 cases with defects and malformations of oral and maxillofacial bone were examined by CT scanning,treated by the implantation of 3D printed implants.Results:Before operation,3D printed model clearly showed the status of the defects and malformations for the precious preoperative implant shaping.The implants for the reconstruction were prepared by 3D print techinique.Perfect reconstruction of the defects was achieved.Conclusion:3 D printing technology exerts promising values in the precious and effective reconstruction of the defects and malformations of maxillofacial bones.
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Objective@#To compare the osteogenic differentiation abilities of human bone marrow mesenchymal stem cells (hBMSCs) from different sources, and to provide basis for choosing a new source of seed cells in bone tissue engineering.@*Methods@# Jaw bone-marrow-derived mesenchymal stem cells (JMMSCs) were isolated from orthognathic surgical sites and cultured by limited dilution for single cell clone. Long bone-marrow-derived mesenchymal stem cells (BMMSCs) were obtained from bone marrow of volunteers and isolated by density gradient centrifugation method. Flow cytometry was used to detect the surface markers of both cells. Osteogenic ability was assessed by PCR and Western Blot after osteogenic differentiation for the following molecules: Runx2, COL-1 and OCN. Alizarin red staining was used for determining the ability of cell mineralization after osteogenic differentiation. @*Results @#The expressions of cell surface markers CD90 and CD105 were positive in both type of cells, while CD34, CD14 and CD45 were all negative. After 21 days of osteogenic induction, JMMSCs formed significantly more mineralized nodules than BMMSCs. After 7, 14, 21 days of osteogenic induction, JMMSCs expressed more osteogenic-related molecules than BMMSCs.@*Conclusion@#The osteogenic differentiation capacity and mineralization ability of JMMSCs are significantly higher than BMMSCs. Jaw bone might be a more suitable source of seed cells in bone tissue engineering compared with long bone.
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Objective @#To investigate aneurysmal bone cyst (ABC) in oral and maxillofacial of clinical appearance, clinical treatment and prognosis.@* Methods @#From July 2003 to December 2015, 8 patients with aneurysmal bone cyst in jaw bone was treated and recorded with the general condition, clinical symptoms, imaging examinations, surgical treatment and prognosis.@*Results @#Among the 8 patients, there were 5 females and 3 males with the age from 5 to 48 years old. 5 cases happened in mandibular bone and 3 cases originated from the maxillary bone. All the patients were primary lesions and diagnosed by pathology. CT scan showed multilocular cystic expansive space occupying lesions, septa, residual bone crest and liquid-liquid form; enhanced imaging showed the tortuous and dilated small blood vessels. Cystic wall composed of spindle shaped fiber cells, tissues and cells, broken bone like multinucleated giant cells and chronic inflammatory cells form and a ribbon like structure, cysts separated by fibrous tissue containing bone and bone fragments, hemorrhage and hemosiderin deposition was observed which was confirmed under the light microscope. The main treatment of aneurysmal bone cyst was radical operation. After 1~6 years of follow-up, no patient was found recurrence. @* Conclusion@# The imaging findings of aneurysmal bone cyst in jaw bone was distintive, with diagnosis of the disease depended on pathology; the main treatment was radical operation with good prognosis.
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Objective:To evaluate the effect of internal distraction osteogenesis in the treatment of complicated teeth-maxillofacial deformity.Methods:Clinical data of 1 0 cases with complicated teeth-maxillofacial deformity were analyzed retrospectively.In the first stage,the patients were operated by internal distraction osteogenesis.In the second stage,the distractor was removed after 3 to 6 months of consolidation period,followed by other operation for further occlusal reconstruction.Results:All the operations were per-formed as planned.The distraction distance was 7 -70 mm.The distraction process was smooth in all the cases.Occlusion was recon-structed and the deformity was corrected by following operation satisfactorily.Conclusion:Internal distraction osteogenesis is effective in the treatment of complicated teeth-maxillofacial deformity for further occlusal reconstruction and functional repair.
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Objective The purpose of the study was to characterize the X-ray and CT findings of ameloblastomas of the jaw.Meth-ods X-ray (n=9)and CT (n=20)findings of 20 patients with pathologically proven ameloblastomas of the jaw were obtained.Image features included location,size,shape,density of the lesion,and changes of adjacent bone were assessed.Results 1 9 cases were located in the mandible,including 10 cases in the molar-ramus region,four cases in the whole half of the mandible body,two cases in the whole half of the mandible body and the opposide mantum,one case in the whole mandible body,two cases in the anterior teeth region and mantum.One case was located in the molar region of the maxilla.Three cases were uniocular and 17 cases were multiocular in shape.All lesions caused expansile changes in the adjacent bone,including expanding towards the lip and bucca(n=15),the lingua(n=3),and expanding uniformly(n=2).The interruptions of the surrounding bone cortex were demonstrated in 1 9 cases.Conclusion There are some characteristic imaging find-ings for ameloblastomas of the jaw.Correct preoperation dignosis can be made on the basis of imaging findings.
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The etiology and pathogenesis of fibro-osseous lesions remain a subject of investigation. Various explanations are offeredcongenital anomaly of bone, developmental defect caused by faulty embryogenesis ; hamartoma, tumor of periodontal membrane origin, mesenchymal tumor arising in spongiosa and an abnormal repair of bone after injury. Fibro-osseous lesions of the jaws form a group of conditions, which are remarkable for their clinicopathological similarities. On occasions clinician may find himself in the position of being the arbiter in the face of equivocal histological evidence. Some pathologists use the same terminology for apparently quite dissimilar lesions, and seemingly others to render the same diagnosis use variable histologic criteria. By analyzing the clinical, radiographic, gross/surgical and histological features of all lesions coded as fibro-osseous lesions we should be able to separate a clinicopathologic entity. A case of cementifying fibroma is presented here along with discussion.
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Objective To make a summary of the clinical application and cooperation of piezosurgery in jaw bone tumour operation. Methods 64 patients with jaw bone tumour were selected since 2007 and were divided into the piezosurgery group and the routine group, they used piezosurgery and routine osteotome respectively. Feelings during operation, operation time, hemorrhage, postoperative reaction and complication were observed and compared. Results Discomfort and hemorrhage during operation was lighter, but operation was longer in the piezosurgery group compared with the routine group. Complications such as postoperative infection, hemorrhage and nerve damage did not occurred. Conclusions Application of piezosurgery in jaw bone tumor operation can increase comfort degree and reduce hemorrhage, it requires proficiency in operation procedures and master key aspects of nursing, so that can cooperate well.
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To construct the recombinant adeno-associated virus (rAAV) vector with human bone morphogenetic protein 7 (BMP7) and observe the BMP7 mRNA expression in vitro, BMP7 CDS se- quence was cloned into expression plasmid pAAV-MCS of AAV Helper Free System. The recombi- nant plasmid was identified with enzyme digestion and sequencing. The recombinant plasmid, pAAV-RC, pHelper were co-transfected into AAV-293 cells according to the calcium phosphate-based protocol. The viral stock was collected by 4 rounds of freeze/thaw. After purified and concentrated,the recombinant virus titer was determined by dot-blot assay. HEK293 cells were transfected with the recombinant virus at different MOI, and the expression of BMP7 mRNA was detected by RT-PCR. The results showed rAAV-BMP7 was constructed and packaged successfully. The physical particle titer was 2.5×1011 vector genomes/mL. There was different expression level of BMP7 mRNA after transfecton. These data suggested that recombinant AAV mediated a stable expression of hBMP7 mRNA in 293 cells. The AAV production method may pave the way of an effective strategy for the jaw bone defection around dental implants.
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The mature cystic teratoma of the ovary (ovarian dermoid cyst) is the most common ovarian neoplasm in young women and comprises approximately 10~25% of all ovarian tumors. There are many complications such as torsion, rupture, infection, suppuration, and rarely malignancy change. Teratoma derives from the three embryonic cell lines and may contain skin, sebaceous tissue, hair, cartilage and bone, neuroglial tissue, gastrointestinal and respiratory tissue, teeth, and muscle. Even though the presence of dental tissue within dermoid cysts has been reported in the literature, the cysts containing jaw bone and teeth are extremely rare. We report a case of ruptured ovarian dermoid cyst containing jaw bones and eight well-formed teeth with a brief review of literature.
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Female , Humans , Cartilage , Cell Line , Dermoid Cyst , Hair , Jaw , Muscles , Ovarian Neoplasms , Ovary , Rupture , Skin , Suppuration , Teratoma , ToothABSTRACT
@#ObjectiveTo observe the clinical effect of titanium plate osteosynthesis in jaw bone fracture.Methods26 cases were treated with titanium plate, and the function of recovery were analyzed.ResultsAfter operation, the patients recovered in phase Ⅰ except one who was malocclusion, periodontium and temporomandibular were affected rarely. It did not limited mouth open; the time of functional recovery was very short.ConclusionThe effect of titanium rigid internal fixation shows well.
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Humans , Diagnosis , Follow-Up Studies , Jaw , Mucous Membrane , Osteoma , Recurrence , Wounds and InjuriesABSTRACT
Objective To discuss the applied value of multislice spiral CT(MSCT) in diagnosing and localizing the embedded supernumerary teeth. Methods A total of 43 cases with the embedded supernumerary teeth were undergone MSCT using shaded surface display(SSD), minimum intensity projection(MIP) and multiplanar reformation(MPR) to present the form and location of the embedded supernumerary teeth and to determine the surgical style.The result of image was retrospectively analysed after operation.Results The reconstruction images,could clearly show the dental surface image including crown, root, neck and root bifurcation, labial or palatal location, eruption orientation and relation with dentition in anterior maxilla. The position of 52 embedded supernumerary teeth in 43 patients were completely confirmed by surgery with accuracy of 100%. All patients were well healed with no infection and injury to nearby teeth. Conclusion The Embedded supernumerary teeth in bone can be detected by MSCT and MSCT can be used as an important examination technique before surgical and orthodontic treatment.
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PURPOSE: The present study was carried out to determine the diagnostic usefulness of bone scan for evaluating jaw bone extension of oral cancer. MATERIALS AND METHODS: Medical records, preoperative bone scans, computerized tomographic (CT) scans, conventional radiographs, and findings of histopathologic sections of twenty patients who had been treated for oral malignant tumors by a resection of mandible and soft tissue at Chonnam University Hospital from January, 1994 to September, 1999 were analyzed. RESULTS: In 13 cases which showed histopathologically positive, preoperative bone scans were positive in 12 (92.3%) and false negative in 1 (7.7%). Preoperative CT scans were positive in 9 (69.2%) and false negative in 4 (30.8%) of the 13 cases. Preoperative conventional radiographs were positive in 8 (61.5%) and false negative in 5 (38.5%) of the 13 cases. In 7 cases showing negative histopathologic findings, 1 (14.3%) was in CT scans and 2 (28.6%) were false positive in preoperative conventional radiographs. CONCLUSION: These results suggest that bone scan is more sensitive and reliable method for evaluating jaw bone extension of oral cancer than conventional radiographs or CT scans.
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Humans , Jaw , Mandible , Medical Records , Mouth Neoplasms , Tomography, X-Ray ComputedABSTRACT
97 cases of jaw bone fractures were treated with rigid internal fixation.16 cases had malocclusion postoperation.The etiology was analyzed and the prevention methods were proposed.Intermaxillary elastic traction or fixation and craniomaxillofacial fixation or craniomentum elastic traction were performed to treat the malocclusion.By this way,14 cases were cured.1 case was operated again to resume the normal occlusion,1 case received occlusal adjustment.Incomplete reduction,incorrect operative performance,deficiency of postoperative intermaxillary fixation and incorrect intermaxillary fixation were the main causes to malocclusion.So anatomic in time reduction,correct operative performance,intermaxillary fixation,application of craniomaxillofacial fixation or craniomentum elastic traction instead of intermaxillary fixation for some special cases are effective methods to correct postoperative malocclusion.