Assessing Long-Term Postoperative Resorption in Mandibular Block Cortical Grafts for Facial Asymmetry Correction: A Retrospective Investigation.

OBJECTIVE: To evaluate the long-term postoperative resorption of the graft mandibular block cortical graft and identify the resorption site following free transplantation into the contralateral mandible. METHODS: In this study, individuals aged 18 years or older with facial asymmetry deformity who underwent free grafting of the mandibular block cortical graft were included. Postoperative computed tomography (CT) data were collected at predetermined intervals. The degree of graft bone absorption postoperatively was quantitatively evaluated using the equation Absorptivity=(VTn-VT0)/VT0 ×100%. The resorption site was qualitatively assessed through a color-coded distance map. RESULTS: Postoperative analysis revealed partial absorption of the transplanted mandibular block cortical graft in the contralateral mandible, predominantly at the lower and posterior mandibular margins. The average decrease of 29.9±6.37% (paired t test, P<0.01). CONCLUSION: The utilization of mandibular block cortical grafts in correcting facial asymmetry results in a low absorption rate and a stable absorption situation, rendering it a safe and effective technique.

Nanofibrous textured silk aerogel with 3D channel arrays and adjustable mechanical properties for bone tissue regeneration.

Bone tissue engineering scaffolds are an important means of repairing bone defects, but current solutions do not adequately simulate complex extracellular microenvironment fibrous structures and adjustable mechanical properties. We use template-assisted fiber freeze-shaping technology to construct silk fibroin nanofiber aerogels (SNFAs) with nanofibrous textures and adjustable mechanical properties. The parallel arranged channels, the pores, electrospun nanofibers, and silk protein conformation together constitute the hierarchical structure of SNFAs. Especially, the introduced electrospun nanofibers formed a biomimetic nanofibrous texture similar to the extracellular matrix, providing favorable conditions for cell migration and tissue regeneration. In addition, Young's modulus of SNFAs can be adjusted freely between 7 and 88 kPa. The rationally designed 3D architecture makes SNFAs perfectly mimic the fiber structure of the extracellular matrix and can adjust its mechanical properties to match the bone tissue perfectly. Finally, fiber-containing SNFAs observably promoted cell adhesion, proliferation, and differentiation, accelerating the bone repair process. The bone density in the defect area reached 0.53 g/cm3 and the bone volume/total volume (BV/TV) ratio reached 57 % at 12 weeks, respectively. It can be expected that this kind of tissue engineering scaffold with highly simulating extracellular matrix microenvironment and adjustable mechanical properties will possess broad prospects in the field of bone repair.

The triglyceride glucose index was nonlinearly associated with all-cause mortality in diabetic patients.

BACKGROUND AND AIM: The TyG index has been linked with cardiometabolic diseases. Our study aimed to investigate the specific relationship between the triglyceride and glucose index (TyG) and both all-cause and cardiovascular mortality in diabetic patients. METHODS AND RESULTS: We enrolled 3120 participants with diabetes from the National Health and Nutrition Examination Survey. The TyG index was calculated using the formula ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Hazard ratios (HRs) of TyG associated with mortality risk were assessed using Cox proportional hazard regression models. Over a follow-up period of 10.8 thousand person-years, we observed 768 all-cause deaths and 155 cardiovascular deaths. Compared to the reference quartile, the multivariate-adjusted hazard ratios and 95% confidence intervals for all-cause mortality were 1.02 (1.01-1.05; p = 0.008) in the fourth quartile. Dose-response analysis revealed a non-linear association. However, no significant associations were found between the TyG index and cardiovascular mortality. CONCLUSIONS: The TyG index exhibited a non-linear association with the risk of all-cause mortality in diabetic patients.

Using a three-dimensional natural head position precise recording and transferring device to translate the natural head position into a 3-dimensional virtual patient: A dental technique.

As computer-assisted surgical design becomes increasingly popular in maxillofacial surgery, the integration of the natural head position (NHP) of a 3-dimensional virtual patient has become a primary problem that orthognathic surgeons have to solve during virtual surgical planning. The present technique describes a way of transferring the horizon orientation of the NHP into a computer-aided design software program with a recently developed NHP recording and transferring device (Patent No. ZL202110992198.6 China). The device can record NHP using 5 marked points which can be visualized radiographically.

Does an incomplete ferrule affect the fracture of endodontically treated teeth? A systematic review of in vitro studies.

OBJECTIVE: The purpose of this systematic review was to assess the impact of the incomplete ferrule on the fracture of endodontically treated teeth (ETT). DATA: The keywords such as "incomplete ferrule," "ferrule," "ferrule effect," "residual dentin," "remaining dentin," or "remaining coronal dentin" were used for searching, and only in vitro studies investigating the incomplete ferrule effect on natural teeth were included. SOURCES: PubMed, Medline, Embase, Cochrane Library, and Science Direct databases, and manual-searching. STUDY SELECTION: The search strategy yielded 1633 hits, and a total of 19 in vitro studies closely related to the effect of incomplete ferrule on ETT were included. CONCLUSION: The presence of an incomplete ferrule may significantly increase the fracture resistance of restored ETT, compared with restored ETT without ferrule. The number of residual axial walls of the incomplete ferrule may have an impact on the fracture resistance and fracture mode. The location of residual axial walls of the incomplete ferrule may affect the fracture resistance but not the fracture mode. CLINICAL IMPLICATIONS: Limited data suggest that the presence of incomplete ferrule has a positive effect on the fracture resistance of restored ETT. An incomplete ferrule can be an alternative for restoring ETT when a complete ferrule is not present. Nevertheless, further high-quality studies are still needed to offer more robust evidence and to take potential confounding factors into account.

Bottom-Up Assembling Hierarchical Enamel-Like Bulk Materials with Excellent Optical and Mechanical Properties for Tooth Restoration.

Enamel has good optical and mechanical properties because of its multiscale hierarchical structure. Biomimetic construction of enamel-like 3D bulk materials at nano-, micro-, mesh- and macro-levels is a challenge. A novel facile, cost-effective, and easy large-scale bottom-up assembly strategy to align 1D hydroxyapatite (HA) nanowires bundles to 3D hierarchical enamel structure with the nanowires bundles layer-by-layer interweaving orientation, is reported. In the strategy, the surface of oleate templated ultralong HA nanowires with a large aspect ratio is functionalized with amphiphilic 10-methacryloyloxydecyl dihydrogen phosphate (MDP). Furtherly, the MDP functionalized HA nanowire bundles are assembled layer-by-layer with oriented fibers in a single layer and cross-locked between layers at a certain angle at mesoscale and macroscale in the viscous bisphenol A-glycidyl methacrylate (Bis-GMA) ethanol solution by shear force induced by simple agitation and high-speed centrifugation. Finally, the excessive Bis-GMA and ethanol are removed, and (Bis-GMA)-(MDP-HA nanowire bundle) matrix is densely packed under hot pressing and polymerized to form bulk enamel-like materials. The composite has superior optical properties and comparable comprehensive mechanic performances through a combination of strength, hardness, toughness, and friction. This method may open new avenues for controlling the nanowires assembly to develop hierarchical nanomaterials with superior properties for many different applications.

Assessment of Masseter Volume and Postoperative Stability After Orthognathic Surgery in Patients With Skeletal Class III Malocclusion With Facial Asymmetry.

OBJECTIVE: This study aimed to evaluate the effect of orthognathic surgery on masseter volume in patients with skeletal Class III malocclusion with facial asymmetry and the effect of masseter volume on stability in orthognathic surgery. METHODS: This research studied 16 patients with Class III malocclusion with facial asymmetry who received combined orthodontic-orthognathic treatment and underwent craniofacial computed tomography (CT) before (T0), 2 weeks after (T1), and 6 months after (T2) surgery. Three-dimensional (3D) CT images were retrospectively analyzed, using 3D volume reconstruction to obtain the masseter volume and examine the impact of the masseter volume on stability in orthognathic surgery. RESULTS: A statistically significant difference ( P < 0.05) in the volume of the masseter was found up to 6 months after orthognathic surgery compared with the preoperative period, and the reduction in the masticatory muscle volume on the lengthened side is greater than on the shortened side ( P < 0.05). The volume of both masseters differed according to facial asymmetry, and the difference was significantly reduced after orthognathic surgery ( P < 0.05). During the period time (T1-T2), cephalometric maxillary marker points were not significantly different ( P > 0.05), and mandibular marker points were significantly anteriorly shifted ( P < 0.05). There was an association between the masseter volume and anterior shift of point B (R > 0.5, P < 0.05), the upward and anterior shifts of the gonion point differed between the lengthened and shortened sides ( P < 0.05). CONCLUSION: The size of the masseter becomes smaller 6 months after orthognathic surgery, and orthognathic surgery improves both bone and soft tissue symmetry. A larger sagittal relapse of mandibular setback occurred in patients with greater masseter volume. Considering these alterations may be helpful in planning orthognathic surgery.

Inferior Alveolar Nerve Repositioning With the Computer-Aided Design in Hemimandibular Hyperplasia.

A 34-year-old man presented with facial asymmetry and was diagnosed with left-sided hemimandibular hyperplasia. Orthognathic surgery and mandibular angle osteotomy combined with inferior alveolar nerve repositioning were performed with computer-aided design. The facial asymmetry was successfully corrected with acceptable cosmetic results. Inferior alveolar nerve repositioning provided sufficient space for the osteotomy of the affected side with the abnormal mandibular canal. Inferior alveolar nerve repositioning with computer-aided design can be used as an effective and reliable technique for hemimandibular hyperplasia.

Mandibular Body Osteotomy Combined with Sagittal Split Ramus Osteotomy for the Treatment of Severe Skeletal Class â ¢ Malocclusion with Ankylosed Teeth.

This study presents a combination of 2 different surgery procedures performed on the mandible as part of the treatment aiming to improve the facial profile and occlusal function of patients with severe skeletal class Ⅲ malocclusion and bilateral edentulous gaps. The teeth next to the edentulous gaps were found to be ankylosed. Mandibular setback by bilateral sagittal split ramus osteotomies and mandibular body osteotomies, combined with Le Fort Ⅰ level maxillary advancement were performed, since the chief complaint of the patient was a concave profile. As a result, the skeletal class Ⅲ malocclusion had been corrected, a satisfying facial profile had been achieved, and no apparent adverse effect was found. Thus, it has been proved that the combination of sagittal split ramus osteotomy and mandibular body osteotomy is available for correcting skeletal class Ⅲ malocclusion.

Quantitative Flow Ratio-Derived Index of Microcirculatory Resistance as a Novel Tool to Identify Microcirculatory Function in Patients with Ischemia and No Obstructive Coronary Artery Disease.

BACKGROUND: Coronary microvascular disease (CMVD) is associated with adverse cardiovascular outcomes. However, there is no reliable and noninvasive quantitative diagnostic method available for CMVD. The use of a pressure wire to measure the index of microcirculatory resistance (IMR) is possible, but it has inevitable practical restrictions. We hypothesized that computation of the quantitative flow ratio could be used to predict CMVD with symptoms of ischemia and no obstructive coronary artery disease (INOCA). METHODS: We retrospectively assessed the diagnostic efficiency of the quantitative flow ratio-derived index of microcirculatory resistance (QMR) in 103 vessels from 66 patients and compared it with invasive IMR using the thermodilution technique. RESULTS: Patients were divided into the CMVD group (41/66, 62.1%) and non-CMVD group (25/66, 37.9%). Pressure wire IMR measurements were made in 103 coronary vessels, including 44 left descending arteries, 18 left circumflex arteries, and 41 right coronary arteries. ROC curve analysis showed a good diagnostic performance of QMR for all arteries (area under the curve = 0.820, 95% confidence interval 0.736-0.904, p < 0.001) in predicting microcirculatory function. The optimal cut-off for QMR to predict microcirculatory function was 266 (sensitivity: 82.9%, specificity: 72.6%, and diagnostic accuracy: 76.7%). CONCLUSION: QMR is a promising tool for the assessment of coronary microcirculation. The assessment of the IMR without the use of a pressure wire may enable more rapid, convenient, and cost-effective assessment of coronary microvascular function.

The prevalence of coronary microvascular dysfunction (CMD) in heart failure with preserved ejection fraction (HFpEF): a systematic review and meta-analysis.

To date, studies on the prevalence of coronary microvascular dysfunction (CMD) in heart failure with preserved ejection fraction (HFpEF) have not been summarized and analyzed as a whole. We conducted this systematic review and meta-analysis to assess the prevalence of CMD in patients with HFpEF. The PubMed, Cochrane, and Embase databases were searched from dates of inception until May 1, 2023. The primary outcome was the prevalence of CMD in patients with HFpEF, and values of CMD prevalence were pooled using a random-effects model. In total, 10 studies involving 1267 patients, including 822 with HFpEF and 445 without HFpEF, were included. The pooled prevalence of CMD in patients with HFpEF was 71% (95% CI, 0.63-0.79). In the subgroup analysis, the prevalence of CMD was 79% (95% CI, 0.71-0.87) by invasive measurement and 66% (95% CI, 0.54-0.77) by noninvasive measurement and 67% (95% CI, 0.52-0.82) with CFR < 2.0 and 75.0% (95% CI, 0.71-0.79) with CFR < 2.5. The prevalence of endothelium-independent CMD and endothelium-dependent CMD was 62% (95% CI, 0.53-0.72) and 50% (95% CI, 0.19-0.81), respectively. The prevalence of CMD was 74% (95% CI = 0.69-0.79) and 66% (95% CI = 0.41-0.90) in prospective and retrospective studies, respectively. Compared with the control group, patients with HFpEF had a significantly lower CFR (MD = - 1.28, 95% CI = - 1.82 to - 0.74, P < 0.01) and a higher prevalence of CMD (RR = 2.21, 95% CI = 1.52 to 3.20, P < 0.01). Qualitative analysis demonstrated that CMD might be associated with poor clinical outcomes in patients with HFpEF. In conclusion, this is the first systematic review and meta-analysis of all studies reporting the prevalence of CMD in patients with HFpEF. Our study demonstrates that CMD is common in patients with HFpEF and might be associated with poor clinical outcomes in these patients. Clinicians should attach importance to CMD in the diagnosis and treatment of HFpEF. The number of studies in this field is relatively small. Therefore, more high-quality studies are needed to explore the diagnostic and prognostic value of CMD and the potential role of CMD as a therapeutic target in patients with HFpEF.

Bibliometric and visual analysis of doxorubicin-induced cardiotoxicity.

Background: Doxorubicin-induced cardiotoxicity represents a prevalent adverse effect encountered in patients undergoing treatment with doxorubicin. To date, there has been no bibliometric study to summarize the field of doxorubicin-induced cardiotoxicity. In our study, we aim to determine the current status and frontiers of doxorubicin-induced cardiotoxicity by bibliometric analysis. Methods: The documents concerning doxorubicin-induced cardiotoxicity are obtained from the Web of Science Core Collection database (WOSCC), and VOSviewer 1.6.16, CiteSpace 5.1.3 and the WOSCC's literature analysis wire were used to conduct the bibliometric analysis. Results: In total, 7,021 publications were encompassed, which are produced by 37,152 authors and 6,659 organizations, 1,323 journals, and 101 countries/regions. The most productive author, institution, country and journal were Bonnie Ky with 35 publications, University of Texas with 190 documents, the United States with 1,912 publications, and PLOS ONE with 120 documents. The first high-cited article was published in the NEJM with 8,134 citations authored by DJ Slamon et al., in 2001. For keyword analysis, there are four clusters depicted in distinct directions. The keywords in the red cluster are oxidative stress, apoptosis, and cardiomyopathy. The keywords in the green cluster are cardiotoxicity, heart failure, and anthracycline. The keywords in the blue cluster are chemotherapy, trastuzumab, and paclitaxel. The keywords in the purple cluster are doxorubicin, adriamycin, and cancer. Most of the documents were derived from the United States, China and Italy (4,080/7,021, 58.1%). The number of studies from other countries should be increased. Conclusion: In conclusion, the main research hotspots and frontiers in the field of doxorubicin-induced cardiotoxicity include the role of doxorubicin in cardiotoxicity, the mechanisms underlying doxorubicin-induced cardiotoxicity, and the development of treatment strategies for doxorubicin-induced cardiotoxicity. More studies are needed to explore the mechanisms and treatment of doxorubicin-induced cardiotoxicity.

A Novel Technique for Resection and Reconstruction of the Temporomandibular Joint by Sliding Vertical Ramus Osteotomy using Only Submandibular Approach.

In this paper, an innovative technique for resection and reconstruction of the temporomandibular joint by sliding vertical ramus osteotomy using only a submandibular approach is presented. Before pulling the posterior mandibular border slightly downward to expose parts of the condyle, the vertical ramus osteotomy was performed. With the help of 3D simulation and surgical templates, the condylectomy was carried out using the ultrasonic osteotome through the submandibular approach. Our technique achieved the desired results while preventing complications of facial nerve paralysis, the occurrence of Frey syndrome, and the preauricular scar. Therefore, we suggest that this surgical method represents an alternative treatment option for temporomandibular joint lesions.

Himi-Lengthening Genioplasty: A Modified Technique for the Correction of Mandibular Asymmetry.

Mandibular asymmetry is among the most common facial anomalies. Traditionally, mandibular asymmetry with malocclusion has been treated with orthognathic surgery and genioplasty. However, routine genioplasty cannot achieve a satisfactory contour. Hence, this study presents a modified technique, himi-lengthening genioplasty, to resolve this matter. By combining this technique with orthognathic surgery, the authors successfully corrected mandibular asymmetry in 1-stage surgery, achieved ideal occlusion, and reconstructed the esthetic contour. No complications occurred during the 6-month follow-up period. Therefore, the authors recommend our modified surgical technique for its effectiveness, security, stability, and simplicity.

Three-dimensional Reconstruction and Comparison of Temporomandibular Joint Space Volume Before and After Orthognathic Surgery in Patients with Skeletal Class III Malocclusion With Mandibular Deviation.

OBJECTIVE: To look into the association between the degree of deviation and the changing trend in the temporomandibular joint (TMJ) space volume after orthognathic surgery in patients with skeletal Class III malocclusion. METHODS: Twenty patients having combined orthodontic-orthognathic treatment for skeletal Class III malocclusions with mandibular deviation were chosen, and craniofacial spiral CT was performed before (T0), two weeks after (T1), and six months after (T2) surgery. Using 3D volume reconstruction, further partitioning, and analysis of each domain's volume changes over time, the TMJ space volume is to be obtained. The differences in changes between groups A (mild deviation group) and B (severe deviation group) were examined to examine the impact of the degree of deviation on the TMJ space volume. RESULTS: A statistically significant difference ( P <0.05) existed between the postoperative TMJ space volume in group A and the preoperative overall, anterolateral, and anteroinferior space volume; the same difference also existed between the postoperative TMJ space volume in the NDS and the preoperative posterolateral, posteroinferior space volume. In group B, the postoperative TMJ space volume was statistically significant ( P <0.05) compared with the preoperative total and anteroinferior space volume in the DS; the difference between the total volume of the T1 stage on the NDS and the total volume of the T0 stage was statistically significant ( P <0.05). The two groups showed substantial differences in the space volume changes between the T1-T0 phase and the T2-T1 period. CONCLUSION: Patients with skeletal Class III malocclusion and mandibular deviation after orthognathic surgery see a change in the TMJ space volume. All patient types experience a largely consistent space volume change trend two weeks after surgery, and the degree of mandibular deviation is correlated with the intensity and longevity of the alteration.

Tumor-promoting roles of HMMR in lung adenocarcinoma.

Searching for differential genes in lung adenocarcinoma (LUAD) is vital for research. Hyaluronan mediated motility receptor (HMMR) promotes malignant progression of cancer patients. However, the molecular regulators of HMMR-mediated LUAD onset are unknown. This work aimed to study the relevance of HMMR to proliferation, migration and invasion of LUAD cells. Let-7c-5p and HMMR levels in LUAD cells and HLF-a cells were assessed, and their correlation was also detected. Their interaction was determined by dual-luciferase experiments and qRT-PCR. Cell proliferation, migration and invasion potentials in vitro were validated through cell counting kit-8 (CCK-8), colony formation, scratch healing, and transwell assays. The expression of HMMR was examined by qRT-PCR and western blot and the expression of let-7c-5p was assayed by qRT-PCR. It was found that HMMR level was increased in LUAD and negatively correlated with let-7c-5p level. Let-7c-5p directly targeted HMMR to repress LUAD cell proliferation, migration and invasion. The above data illustrated that the let-7c-5p/HMMR axis may provide certain therapeutic value for LUAD patients.

Superhydrophobic film from silicone-modified nanocellulose and waterborne polyurethane through simple sanding process.

How to improve the water and pollution resistance of films has been a major stumbling block in applications of waterborne coatings. To solve this problem, a new strategy was developed to construct waterborne superhydrophobic polyurethane composite films by modifying cellulose nanocrystal (CNC) with polysiloxane and doping the modified CNC into waterborne polyurethane (WPU). The super-hydrophobic functionalization with a water contact angle >150° was achieved by simple sanding. The effects of CNC on the morphology, thermal, mechanical, and hydrophobic properties of the obtained superhydrophobic composite films were investigated. The simple sanding process formed a large number of rough porous structures on the surface of the film, which improved the superhydrophobic properties of the film. And after 30 sanding cycles, the film still had excellent hydrophobicity (water contact angle >150°). This easy and effective method for the preparation of superhydrophobic films has great practical application value in the area of waterborne coatings.

Modified Le Fort I Arc Osteotomy Combined With Autologous Bone Grafts to Improve Midface Hypoplasia Combined With Skeletal Class III Malocclusion: A Technical Note.

Midface hypoplasia sometimes appears in patients with skeletal class III malocclusion in the Asian population, often requires additional surgical treatments. The technical note is intended to introduce a modified Le Fort I arc osteotomy combined with autologous bone grafts harvested from proximal segments after bilateral sagittal split ramus osteotomy to improve the profile for skeletal class III malocclusion patients with midface hypoplasia. The benefit of the modified technology is that the size and position of the arc can be adjusted according to the severity of the deformity to suit different patients. In addition, the application of autologous bone grafts increased the extra height of osteotomy line and enhanced the surgical effect, and maintained bone consolidation. More importantly, the osteotomy line of the modified Le Fort I arc osteotomy can be easily designed and this modification will not cause additional injuries. Therefore, we believe that for skeletal class III malocclusion patients with midface hypoplasia in Asia modified Le Fort I arc osteotomy combined with autologous bone grafts will be an efficient surgical method to improve midface hypoplasia.

Application of 3D-printed Surgical Cutting Guide in Anterior Mandibular Body Ostectomy.

Complications in mandibular surgeries involve nerve and root injuries. Due to the variation of the intraosseous pattern of the inferior alveolar nerve and roots among patients, the risk of injury remains high in complex cases of mandibular body surgeries. This technical note aims to introduce a novel design of surgical cutting guide used in anterior mandibular body ostectomy. Roots of neighboring teeth and the inferior alveolar nerve are segmented and visualized in 3-dimension. Osteotomy planes designed in virtual surgical planning provide an accurate safety distance to the nerve and roots. These planes are translated to a bone-based cutting guide to ensure the osteotomy is conducted as planned. Application of the cutting guide offers protection to the neighboring structures and the simplified structure requires limited preoperative design time of the cutting guide. Therefore, the authors believe this surgical cutting guide would bring accuracy and efficiency to mandibular surgeries.

The impacts of Ramadan fasting for patients with non-alcoholic fatty liver disease (NAFLD): a systematic review.

Background: Numerous studies have explored the impacts of Ramadan fasting on Non-alcoholic fatty liver disease (NAFLD). Therefore, the objective of this systematic review was to analyze and summarize all clinical studies regarding the impacts of Ramadan fasting for patients with NAFLD. Methods: We performed a comprehensive search of the Embase, Cochrane, and PubMed databases from inception to September 1, 2023. All clinical studies concerning the impacts of Ramadan fasting on patients with NAFLD were included. Results: In total, six studies with 397 NAFLD patients comprising five prospective studies and one retrospective study were included in the systematic review. All six studies were assessed as high-quality. Ramadan fasting may offer potential benefits for patients with NAFLD, including improvements in body weight, body composition, cardiometabolic risk factors, glucose profiles, liver parameters, and inflammation markers. Conclusion: Ramadan fasting might be an effective dietary intervention for NAFLD. However, the number of studies examining the impacts of Ramadan fasting for patients with NAFLD is relatively limited. Therefore, more high-quality research is needed to further our understanding of the benefits of Ramadan fasting for NAFLD. Systematic review registration: https://inplasy.com, identifier 202390102.