Developments and trends of endoscopic salivary gland resection: from endoscope-assisted to full endoscopic / 华西口腔医学杂志

More than 30 years of rapid development of endoscopic surgery has led to the mainstreaming of this procedure in many surgical departments in China. Since the first report on endoscopy, it has been used in salivary gland resection for more than 20 years. The overall development of endoscopic surgery indicates that its use in oral and maxillofacial surgery is still in the early exploration stage; it has not yet been maturely developed or applied. Owing to the advancement of other disciplines and corresponding widening experiences in those fields, the development of endoscopic technology in oral and maxillofacial surgery will likely achieve a leapfrogging. Learning from the general development pattern of endoscopy, this research explores the application history, current situation, and future direction of the application of endoscopy in salivary gland surgery.

Promotion effect of TGF-β-Zfp423-ApoD pathway on lip sensory recovery after nerve sacrifice caused by nerve collateral compensation / 国际口腔科学杂志·英文版

Resection of oral and maxillofacial tumors is often accompanied by the inferior alveolar nerve neurectomy, resulting in abnormal sensation in lower lip. It is generally believed that spontaneous sensory recovery in this nerve injury is difficult. However, during our follow-up, patients with inferior alveolar nerve sacrifice showed different degrees of lower lip sensory recovery. In this study, a prospective cohort study was conducted to demonstrate this phenomenon and analyze the factors influencing sensory recovery. A mental nerve transection model of Thy1-YFP mice and tissue clearing technique were used to explore possible mechanisms in this process. Gene silencing and overexpression experiments were then conducted to detect the changes in cell morphology and molecular markers. In our follow-up, 75% of patients with unilateral inferior alveolar nerve neurectomy had complete sensory recovery of the lower lip 12 months postoperatively. Patients with younger age, malignant tumors, and preservation of ipsilateral buccal and lingual nerves had a shorter recovery time. The buccal nerve collateral sprouting compensation was observed in the lower lip tissue of Thy1-YFP mice. ApoD was demonstrated to be involved in axon growth and peripheral nerve sensory recovery in the animal model. TGF-β inhibited the expression of STAT3 and the transcription of ApoD in Schwann cells through Zfp423. Overall, after sacrificing the inferior alveolar nerve, the collateral compensation of the ipsilateral buccal nerve could innervate the sensation. And this process was regulated by TGF-β-Zfp423-ApoD pathway.

Diagnosis, treatment and prognosis of human major exocrine ductal carcinoma / 国际肿瘤学杂志

Exocrine ductal carcinoma is an important part of malignant tumors of exocrine glands, including invasive breast ductal carcinoma, salivary duct carcinoma, pancreatic ductal adenocarcinoma and cholangiocarcinoma. Most of these diseases are aggressive, highly malignant and endanger human health. Early detection and diagnosis are the key to a good prognosis for exocrine ductal carcinoma. Different exocrine ductal carcinomas also have certain connections, and their molecular biological characteristics, pathological characteristics and molecular mechanisms have similarities. Surgical resection combined with adjuvant radiotherapy and chemotherapy is currently a common treatment method for exocrine ductal carcinoma. At the same time, its related targeted therapy and immunotherapy sites can also learn from each other. Human epidermal growth factor receptor-2 (HER-2) and the family markers have become breast ductal carcinoma and salivary duct carcinoma targeted therapy sites, and immunotherapy at programmed death ligand 1 (PD-L1) sites has also been involved in many studies, but there is no clear conclusion yet.

Progress in the mechanism of estrogen receptors in skeletal muscle diseases / 国际儿科学杂志

Estrogen receptors are steroid receptors, widely distributed in skeletal muscle, liver and other tissues.Currently, there are 5 known estrogen receptors.Different estrogen receptors are distributed in different places and have different functions.By mediating different estrogen receptors, estrogen plays an important role in anti-inflammation, promoting proliferation and inhibiting muscle atrophy.Skeletal muscle is the main tissue in the human body, accounting for about 40% of body weight.Skeletal muscle not only plays the role of exercise and support, but also plays an important role in maintaining the body′s metabolism.In recent years, estrogen receptors have received extensive attention in skeletal muscle diseases.Estrogen receptors are considered as potential targets for the treatment of skeletal muscle diseases such as Duchenne muscular dystrophy(DMD)and myotubular myopathy(MTM). This article reviews the research progress of estrogen receptors in skeletal muscle diseases.

Survival Association and Cell Cycle Effects of B7H3 in Neuroblastoma

Objective@#: The function of B7H3, a member of the B7 family of proteins, in neuroblastoma (NB) remains poorly characterized. Here we examine the expression pattern of B7H3 in clinical NB specimens and characterize the phenotype of B7H3 knock-down in NB cell line. @*Methods@#: Immunohistochemical (IHC) staining was carried out to assess the expression of B7H3 in clinical NB specimens. Survival association was analyzed using five Gene Expression Omnibus (GEO) datasets (GSE85047, GSE45480, GSE62564, GSE16476, GSE49710). Clonogenic survival and flow cytometry were performed after B7H3 knockdown to assess the cellular proliferation and cell survival in vitro. Impact of B7H3 silencing on NB growth was examined in vivo using the SH-SY5Y xenograft model. @*Results@#: On IHC staining, B7H3 was widely expressed in clinical NB specimens. Analysis of the transcriptional profiles of five GEO datasets clinically annotated NB specimens revealed that decreased B7H3 expression was associated with improved overall survival. B7H3 knockdown suppressed the proliferation of the SH-SY5Y NB model in vitro and in vivo. Cell cycle analysis revealed that B7H3 silencing induced G1/S arrest. This arrest was associated with the suppression of E2F1 expression and induction of Rb expression. @*Conclusion@#: Our results demonstrate that B7H3 expression correlate with clinical survival in NB patients. Preliminary studies suggest that B7H3 may mediate the G1/S transition.

Perforated maxillofacial defect repaired by anteromedial thigh flap instead of anterolateral thigh flap: a case report / 华西口腔医学杂志

Anterolateral thigh flap is perfect for reconstructing maxillofacial soft tissue defects. This tissue has been widely used by clinicians, but often causes operation difficulties because of vascular variation. In this paper, we report a case where anteromedial thigh was used as new donor site when the vascular anatomic variation of anterolateral thigh perforator flap induced a failure in the flap harvest. Moreover, this paper discusses the anatomy and application of anteromedial thigh flap.

Systematic review of magnetic resonance imaging in diagnosing mandibular invasion caused by oral cancers / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic value of magnetic resonance (MR) imaging in the diagnosis of mandibular invasion caused by oral cancers.</p><p><b>METHODS</b>Medline, EMBASE, SIGLE, and Chinese biomedical literature database were searched electronically. Manual searching for 19 relevant Chinese journals was also performed. Two reviewers evaluated the literature and extracted the data. Meta-Disc 1.4 was chosen to conduct the sensitivity (SEN), specificity (SPE), and 95% confidence interval (95%CI).</p><p><b>RESULTS</b>Twelve studies with a total of 476 patients, namely, 5 prospective studies and 7 retrospective studies, were included. All the studies had unclear risk of bias. Meta-analysis result showed that the combination of SEN of MR in diagnosing mandibular invasion was 0.779 (95%CI: 0.719-0.831), combination of SPE was 0.823 (95%CI: 0.767-0.870), positive likelihood ratio was 3.442 (95%CI: 2.181-5.431), negative likelihood ratio was 0.286 (95%CI: 0.181- 0.451), and diagnostic odds ratio was 25.702 (95%CI: 13.406-49.273). The area under curve was 0.903 9 and Q* was 0.835 4. Meta-analysis was not processed when diagnosing mandibular medullary invasion because only two studies with 55 patients had been reported. The SEN was 0.838, and the SPE was 0.722.</p><p><b>CONCLUSION</b>MR is efficient and has clinical value in the diagnosis of mandibular invasion caused by oral cancer.</p>

Central adenoid cystic carcinoma of the mandible: a case report / 华西口腔医学杂志

Central malignant salivary gland tumor of the mandible is rarely observed with adenoid cystic carcinoma, which only comprises a small proportion of cancer patients. In this study, a patient with central adenoid cystic carcinoma of the mandible is presented, and relevant literature is reviewed.

The clinical application of absorbable internal fixation system in maxillofacial fractures：systematic review and Meta-analysis / 中国组织工程研究

BACKGROUND:There are numerous clinical studies on comparing absorbable internal fixation system and titanium metal internal fixation system in maxilofacial fractures; however, the systematic reviews and Meta-analysis in this field are rare. OBJECTIVE:To compare the clinical effect of absorbable internal fixation system and titanium internal fixation system in maxilofacial fractures through systematic review and Meta-analysis. MATERIALS AND METHODS:The randomized controled trials and controled clinical trials regarding the application of absorbable internal fixation system and titanium internal fixation system in maxilofacial fractures were electronicaly retrieved from Medline, Embase, the Cochrane Central Register of Controled Trials, China Biology Medicine disc, and China Academic Journal Network Publishing Database using the keywords. Meta-analysis was conducted using Revman 5.3 software. RESULTS AND CONCLUSION:Thirteen clinical studies were included, and totaly 1 718 patients were involved. The Meta-analysis results showed that the removal rate of implants in the absorbable internal fixation system group was significantly lower than that in the titanium internal fixation group (P=0.000 2); there were no significant differences in the healing rate of fracture I stage, the incidence of insufficient fixation in fracture site and the incidence of long-term complications between these two groups. These results demonstrate that the efficiency and safety of absorbable internal fixation system in maxillofacial fracture is satisfactory, and can reduce the proportion of secondary surgical removal of the implant. More randomized controlled trials should be conducted to confirm this conclusion.

Absorbable collagen membrane for secondary alveolar bone grafting in alveolar cleft surgery：safety and effectiveness / 中国组织工程研究

BACKGROUND:Absorbable colagen membrane can be theoreticaly applied to secondary alveolar bone grafting in alveolar cleft surgery, which can improve the bone preservation and slow bone resorption. However, there is stil no unified conclusion. OBJECTIVE:To assess the efficacy and safety of absorbable colagen membrane for secondary alveolar bone grafting viaa systematic review. METHODS:MEDLINE, EMBASE, CBM and CAJD were searched for eligible articles addressing clinical randomized controled or controled trials of absorbable colagen membrane for secondary alveolar bone grafting. Test group received bone grafting with absorbable colagen membrane and control group only received bone grafting. Meta-analysis on the clinical success rate of bone grafting and incidence of complications in the recipient region was delivered with Revman 5.3. RESULTS AND CONCLUSION:Five clinical trials, involving 416 cleft sites and 387 participants, were included. Two had high risk of bias and the rest had unclear risk of bias. If “the height of new bone is≥ 50% of alveolar height” was adopted as clinical success, the clinical success rate of the test group was significantly higher than that of the control group (P=0.002, relative risk value=1.33, 95% confidence interval [1.11, 1.60]). If “the height of new bone is≥ 75% of alveolar height” was chosen as clinical success, the clinical success rate of the test group was higher than that of the control group, but there was no significant difference between the two groups (P=0.06, relative risk value=1.40, 95% confidence interval [0.99, 1.99]). For safety, the use of absorbable colagen membrane could not increase the complications incidence (P=0.35, relative risk value=0.66, 95% confidence interval [0.28, 1.58]). So, the use of absorbable colagen membrane is safe to improve the clinical success rate of secondary alveolar bone grafting in alveolar cleft surgery. More randomized controled trials should be considered to reinforce the conclusion.

Developmental toxicity of muscone on zebrafish embryos / 中国药理学与毒理学杂志

OBJECTIVE To investigate the develop mental toxicity of muscone to embryos. METHODS With zebrafish embryos as a model,The 3 h post fertilization (hpf)embryos were exposed to muscone at 5,10,20,40,80 and 160 μmol·L -1 culture solutions for 96 h and inspected daily with mi-croscopy for larval morphology.The drug solution was replaced every 24 h.Spontaneous move ments were checked at 24 hpf.Heart rate at 48 hpf,hatching rate,e mbryo deformity rate and mortality rate were evaluated.The expression of sepn1 was determined with real-ti me quantitative PCR technique at 96 hpf.RESULTS The 24 hpf spontaneous move ments showed no significant difference.At 48 hpf, spine curvature,pericardial ede ma,yolk sac ede ma,and abnormal swi mming were observed.In addition, the 48 hpf heart beats(10 s)was decreased fro m 26.5 ±1 .0 to 18.0 ±1 .9(P <0.01 ).At 48 hpf , hatching rate of 5 ~40 μmol·L -1 decreased(P <0.05),while of 160 μmol·L -1 increased (P <0.05) co mpared with muscone 0 μmol·L -1 .Muscone had little effect on hatching rate at other ti me points;Mal-formation rate and mortality rate at higher concentrations were up to 100%.The sepn1 gene expression at 96 hpf in the exposure groups decreased co mpared with that of control group(P <0.01 ).CONCLU-SION Muscone had toxic effects on the develop ment of zebrafish embryos,including spine curvature, abnormal swi mming,and pericardial ede ma.These effects may be related to the inhibition of sepn1 gene expression by muscone.

Huge tumor resection defects on the parotid region repaired by lateral thoracic flap: a case report / 华西口腔医学杂志

Lateral thoracic flap is a free flap for the reconstruction of soft tissue defects and has been previously used in oral and maxillofacial surgeries. We reported a case involving a huge soft tissue defect on the parotid region caused by the resection of parotid epithelial myoepithelial carcinoma. We discussed the anatomy and application of the lateral thoracic flap.

The molecular mechanism between interstitial fluid pressure and malignant phenotype of salivary adenoid cystic carcinoma / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To explore the effects of stress imposed on adenoid cystic carcinoma (ACC), therefore to clarify the molecular basis and mechanism of ACC's malignant phenotype under the elevated tumor interstitial fluid pressure.</p><p><b>METHODS</b>ACC cells were cultured under pressure (103.74 kPa), and were divided into four groups (3 h group, 6 h group, 12 h group, 24 h group) according the pressure time. Untreated ACC2 was as negative control group, untreated ACCM was as positive control group. The level of epidermal growth factor receptor (EGFR) was detected by semiquantitative analysis of immunochemistry. Matrix metalloproteinase 9 (MMP9) and EGFR mRNA expression were assessed by reverse transcriptase polymerase chain reaction. EGFR, phosphorylation epidermal growth factor receptor (P-EGFR), MMP9, keratinocyte growth factor (KGF) and phosphorylation extracellular signal-regulated kinase (P-ERK) protein expressions were assessed by Western blot.</p><p><b>RESULTS</b>As the extension of pressure time, the expression of EGFR, P-EGFR, MMP9, KGF, P-ERK in ACC2 gradually increased, which were positive correlation with pressure time, and were higher than that of negative control group.</p><p><b>CONCLUSION</b>Under the stimulation of pressure, the mRNA and protein levels of adhesion molecules and metastatic relative molecules in ACC2 were sharply elevated.</p>

Assessment of reliability and validity of assessment of multiple systematic reviews in Chinese systematic reviews on stomatology / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To measure the agreement, reliability and validity of assessment of multiple systematic reviews (AMSTAR) to assess Chinese systematic reviews on stomatology.</p><p><b>METHODS</b>A comprehensive electronic search was made through Chinese BioMedical Literature Database, VIP Database for Chinese Technical Periodicals and China National Knowledge Infrastructure electronically on March 1st 2011 together with handsearch through 19 stomatological journals to identify published Chinese systematic reviews on stomatology. Each systematic review was assessed by two reviewers with overview quality assessment questionnaire (OQAQ) and AMSTAR. And reliability (interobserver Kappa of the 11 AMSTAR items), interclass correlation coefficient (ICC) of the sum scores and construct validity (ICC of the sum scores of AMSTAR compared with those of the OQAQ) were reported.</p><p><b>RESULTS</b>A total of 52 systematic reviews on stomatology were eligible. The reviewers agreement of the individual items of AMSTAR was with a mean Kappa of 0.81 [95% CI(0.73, 0.89)] while the OQAQ was 0.74 [95% CI (0.66, 0.83)]. The ICC of the total score for AMSTAR was 0.98 [95% CI (0.97, 0.99), P = 0.000]. Cronbach' alpha was 0.69 [95% CI (0.56, 0.80), P = 0.000]. And ICC of the sum scores of AMSTAR compared with those of the OQAQ was 0.94 [95% CI (0.90, 0.97), P = 0.000].</p><p><b>CONCLUSION</b>AMSTAR has good agreement, reliability and validity. AMSTAR can be well used in Chinese stomatology and can bring dentists much convenience when assess the methodological quality of systematical reviews on stomatology.</p>

Systematic review on control of swelling and trismus after extraction of impacted mandibular third molar by dexamethasone pericoronal injection / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To assess the efficacy of Dexamethasone (DM) pericoronal injection for the control of swelling and trismus caused by impacted mandibular third molars extraction.</p><p><b>METHODS</b>Cochrane, PUBMED, EMBASE and CBM were searched for eligible studies. Hand-searching included references of the included studies and Chinese dental journals. Risk of bias of the included studies was assessed by two reviewers independently using Cochrane Collaboration's tool, and data extraction was done by them. Meta-analysis was delivered with Revman 5.1.</p><p><b>RESULTS</b>Seven randomized controlled trials, involving 684 participants, were included. Six of them had moderate risk of bias and one had high risk of bias. Meta-analysis showed that DM pericoronal injection could relieve trismus by 6.77 mm (P=0.02) within 1-2 days after the surgery. It could also reduce 51% of the risk of moderate-severe trismus(P<0.000 01) and could significantly control facial swelling (P<0.05). There was no differences between 4 mg and 8 mg DM (P>0.05).</p><p><b>CONCLUSION</b>Periodontal injection of 4-5 mg DM could control facial swelling and trismus following impacted mandibular third molar extraction. But more randomized controlled trials are needed.</p>

Periodontal treatment for cardiovascular risk factors: a systematic review / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of periodontal treatment for the management of cardiovascular risk factors.</p><p><b>METHODS</b>Eligible studies in Cochrane Controlled Trials Register/CENTRAL, PubMed, EMBASE, and China Biology Medicine disc (CBMdisc) were searched until October 13, 2011. References of the included studies were hand searched. Two reviewers assessed the risk of bias and extracted the data of the included studies in duplicate. Meta-analysis was conducted with Revman 5.1.</p><p><b>RESULTS</b>Six randomized controlled trials involving 682 participants were included. One case had low risk of bias, another one had moderate risk of bias, and the remaining four had high risk of bias. Meta-analysis showed that periodontal treatment has no significant effect on C-reactive protein, total cholesterol, low-density lipoprotein cholesterol, and triglycerides (P > 0.05). However, the treatment had a significant effect on high-density lipoprotein cholesterol [MD = 0.05, 95% CI (0.00, 0.09), P = 0.04].</p><p><b>CONCLUSION</b>Periodontal treatment has good effects on controlling high-density lipoprotein cholesterol although more randomized controlled trials must be conducted to verify its effectiveness.</p>

Assessment of reporting quality of randomized controlled trial related to dentine hypersensitivity / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To assess the reporting quality of randomized controlled trials (RCT) related to dentine hypersensitivity which were published between 2000 and 2009 in nineteen Chinese stomatological journals, learn the current status and the influence factors of reporting quality of the dentine hypersensitivity RCT, and determine whether they can provide high quality evidence clinically.</p><p><b>METHODS</b>A handsearching of nineteen Chinese stomatological journals to identify dentine hypersensitivity RCT which were published between 2000 and 2009 and labeled "random". Assess the reporting quality of these RCT by Consolidated Standards of Reporting Trials (CONSORT) statement and then analyze the influence factors of reporting quality by univariate and multivariate analyses.</p><p><b>RESULTS</b>We identified 61 dentine hypersensitivity RCT, among which 45 belonged to journals of Chinese scientific study statistical source and 16 belonged to journals of non-statistical source. The reporting quality of dentine hypersensitivity RCT was not high at large and the CONSORT score was 8.1 +/- 2.4 on average. Multiple linear regression showed that the score of improved Jadad scale (t=4.656, P=0.000) was the main influence factor of reporting quality of dentine hypersensitivity RCT. The better the intrinsic authenticity was, the higher the reporting quality would be.</p><p><b>CONCLUSION</b>Currently, reporting quality of Chinese dentine hypersensitivity RCT needs to be improved. In order to improve the reporting quality of dentine hypersensitivity RCT, experts in stomatology should not only improve experimental design before experiments, but also write papers in accordance with CONSORT statement.</p>

Quality assessment on reports of randomized controlled trials of oral and maxillofacial surgery in China / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the report quality of randomized controlled trials (RCT) of oral and maxillofacial surgery in China during 2000-2009.</p><p><b>METHODS</b>A comprehensive electronic search was carried out through Chinese Biomedical Literature Database (CBM), VIP Database for Chinese Technical Periodicals (VIP) and China National Knowledge Infrastructure (CNKI), and 19 kinds of journals of stomatology in China were also hand-searched. We identified RCT published between 2000 and 2009, and classified into oral and maxillofacial surgery and labeled "random" and assessed the quality of these reports using the consolidated standards of reporting trials (CONSORT) statement.</p><p><b>RESULTS</b>53 RCT articles were included. Reporting quality of the 53 articles was not high and the CONSORT score was 8.2 +/- 2.5.</p><p><b>CONCLUSION</b>The reporting quality of RCT of oral and maxillofacial surgery in China is poor. The CONSORT statement should be used to standardize the reporting of RCT.</p>

Drainage for the control of complications after extraction of impacted mandibular third molar: a systematic review / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To assess the efficacy and safety of drainage for the control of the complications following impacted mandibular third molar extraction.</p><p><b>METHODS</b>To retrieve randomized controlled trials assessing the efficacy and safety of drainage for the control of the complications following impacted mandibular third molar extraction, bibliographic databases including MEDLINE, Cochrane Controlled Trials Register, EMBASE, OPEN SIGLE and China Biology Medicine Database (CBM) were searched on August 23th 2011. References of the included studies and Chinese dental journals were hand-searched. The risk of bias were used by Cochrane Collaboration's tool and the data were extracted. Meta-analysis was done with Revman 5.1.</p><p><b>RESULTS</b>Nine articles met the eligibility criteria and were included, seven randomized controlled trials and 2 quasi-randomized controlled trials. Seven of these studies had unclear risk of bias and 2 had high risk of bias. Drainage could significantly increase 4.44 mm of the post-operative maximal mouth opening (P = 0.003), relief facial swelling (P < 0.05) and reduce post-operative complications (P = 0.008). But no evidence showed that drainage had a positive effects on post-operative pain (P = 0.09).</p><p><b>CONCLUSION</b>Drainage could probably control the complications following impacted mandibular third molar extraction; but more randomized controlled trials are needed to reinforce the conclusion.</p>

Application of dental chairside evidence-based medicine for the treatment temporomandibular osteoarthritis / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To obtain an evidence-based treatment for an adolescent patient with temporomandibular osteoarthritis.</p><p><b>METHODS</b>The detailed history of an adolescent patient with temporomandibular osteoarthritis was analysed. Clinical Evidence (to Dec 2010), National Guideline Clearinghouse (2000-Dec 2010), Cochrane Library (Issue 4, 2010), MEDLINE(OVID, 1950-Dec 2010) and China Biology Medicine Database (1978-Dec 2010) were searched to obtain evidence such as clinical guidelines, systematic reviews and randomized controlled trials related to surgery or conservative treatment to temporomandibular osteoarthritis to find a personal treatment strategy for the patient.</p><p><b>RESULTS</b>Five articles were finally included, i.e. 1 clinical guideline, 3 systematic reviews and 1 randomized controlled trials. These evidence showed that: Conservative treatment like intra-articular injection instead of surgery should be adopted for adolescent patient; hyaluronate is the drug with sufficient evidence in supporting its use in treating temporomandibular disorders; inferior temporomandibular joint cavity injection or both upper and lower cavity injection has better effect than that of superior cavity injection only; and there was some evidence to support the use of glucosamine to treat temporomandibular disorders. Considering the situation of the case and the clinical evidence, an individual treatment plan of hyaluronate injection into the upper and lower cavity and glucosamine take orally was established. A long-term follow-up of 6 months showed a good treatment outcome.</p><p><b>CONCLUSION</b>Through the evidence-based methods and the use of clinical evidence, an individual treatment plan could be established for each patient with temporomandibular disorders, and this will provide strong supporting to the treatment of temporomandibular disorders. Up to now, it is clear that hyaluronate injection into the upper and lower cavity with glucosamine administration is effective in treating temporomandibular osteoarthritis.</p>