Application of modified articular disc anchorage in treating the perforation and rupture of temporomandibular joint disc / 华西口腔医学杂志

OBJECTIVES@#This study aimed to use modified articular disc anchorage in treating old irreducible temporomandibular joint (TMJ) disc displacement with perforation and rupture, as well as to explore its efficacy.@*METHODS@#A total of 31 patients (34 sides) with 47 TMJ disc perforations who underwent surgical treatment in the Affiliated Stomatolo-gical Hospital of Nanchang University from January 2018 to December 2021 were selected. According to the location of disc perforation, it has five types: posterior disc perforation (typeⅠ), anterior disc perforation (typeⅡ), lateral disc perforation (type Ⅲ), composite disc perforation, and destruction disc perforation. The modified methods of disc anchoring were divided into two types according to the location of the perforation. TypesⅠandⅢ disc perforation were trea-ted by posterior anchoring method. For posterior ancho-ring, a screw was implanted into the posterolateral side of the condylar neck, and the disc was fixed on the screw by horizontal mattress suture. TypeⅡdisc perforation and compo-site disc perforation combined typeⅡperforation were treated by anterior and posterior double-anchoring method. For anterior anchoring, anchor screws or holes were placed at the anterior edge of the condylar neck, and horizontal mattress suture was performed at the posterior edge of the anterior perforation with an anchor wire. The articular disc was then fixed on the anchor screws or holes. For the posterior anchoring method, it was the same as the previous one. Paired t test was used to analyze the visual analog scale (VAS), maximum interincisal opening (MIO), and TMJ disorder index (CMI) of the patient before surgery and 1, 3, and 6 months after surgery. Disk-condyle position relationship by magnetic resonance imaging and postoperative quality of life in postoperative were analyzed.@*RESULTS@#The incidence of perforation was 41.2% (14/34) in typeⅠ, 11.8% (4/34) in typeⅡ, 8.8% (3/34) in typeⅢ, 29.4% (10/34) in composite type, and 8.8% (3/34) in destruction type. The VAS, MIO, and CMI at 3, 6 months after operation significantly improved compared with those before operation (P<0.05). The effective reduction rate of disc was 96.77% (30/31). The quality of life at 6 months after surgery was 47.22±2.13, and the rate of excellent evaluation was 96.4% (27/28).@*CONCLUSIONS@#Modified articular disc anchorage achieves a good curative effect for treating temporomandibular joint disc perforation and rupture. Nevertheless, its long-term effect requires further observation.

Synthesis and characteristics of integrated bionic mandibular condylar scaffold / 华西口腔医学杂志

<p><b>UNLABELLED</b>OBJECTIVE This study aims to construct a chitosan (CS)-polycaprolactone (PCL)-hydroxyapatite (HA) composite biomimetic scaffold to replace condyle and to explore the tissue engineering applications of condylar.</p><p><b>METHODS</b>A resin mold of the mandibular condyle was prepared by using rapid prototyping techniques. A mandibular condylar integrated biomimetic scaffold model was prepared by solution casting-ice Lek. PCL and CS were mixed at a ratio of 4:1. HA at quality ratios of 40%, 50%, 60%, and 70% was added to groups a, b, c, and d, respectively. The microscopic morphology, porosity, infrared spectra, X-ray diffraction pattern, and mechanical properties of the scaffold were observed.</p><p><b>RESULTS</b>The scaffold that includes both upper and lower parts displayed the same features (i.e., shape, yellow-white appearance, and hard texture) as the mandibular condyle. Scanning electron microscopy showed that the composite scaffold had a 3D network spatial structure, 70%-85% porosity, and 10-200 µm pore size. Infrared spectra showed that the peak intensity reduced with decreasing HA content. X-ray diffraction showed that the diffraction peak decreased with increasing HA content. Suitable tensile and compressive and flexural strength were discovered in the presence of 50% HA.</p><p><b>CONCLUSION</b>The scaffold prepared by solution casting-ice Lek shows favorable comprehensive features and is expected to replace human condylar.</p>

Osteotomy of mandible ascending ramus by “a cover of box” manner provides a surgical approach to large tumors in the parapharyngeal space / 实用口腔医学杂志

Objective:To explore an improved osteotomy of mandible ascending ramus for the surgical approach to large tumors in parapharyngeal space.Methods:According to the operation of parotid gland, masseter muscle was cut near the border of mandibular angle till subperiosteum dissection to mandibular notch, vertical osteotomy outside mandibular foramen to 1.0 cm under mandibular notch, vertical to posterior border of ascending ramus, tumor was exposed and removed, bone plate was repositioned and fixed with titanium. Results:Tumors were completely removed in this way in 3 patients without complications. Conclusion:This surgical approach is suitable for the surgical removal of parapharyngeal interstitial giantism tumor.