Conservative management of mandibular fractures in pediatric patients during the growing phase with splint fiber and ligature arch wire.

PURPOSE: The purpose of this article is to discuss the effective management of mandibular fractures in pediatric patients during the growing phase of the mandible using splint fiber and ligature wire. METHODS: A retrospective study examined pediatric patients with mandibular fractures who were treated using the splint (Quartz) fiber and ligature wire technique at the Stomatology Hospital of Xi'an Jiaotong University from August 2021 to January 2023. Data on gender, age, location or site of the fracture, and development of tooth stage were collected from the patient's medical records. Descriptive statistics were used to analyze the data and evaluate the effectiveness of the splint (Quartz) fiber technique for treating mandibular fractures in pediatric patients. RESULTS: Out of 256 subjects, 6 pediatric patients with mandibular fractures were selected, resulting in an incidence rate of 2.34% with an equal sex ratio. Mental or symphysis fracture was the most common site for fracture in children, accounting for 100% of cases. Right mandibular angle fracture was observed in 16.7% of patients, while 50% of the group (3 individuals) suffered from left condylar fracture and 16.7% had a bilateral condylar fracture. Treatment with Quartz splint fiber and circumdental arch wiring using ligature wire was successful with no observed post-treatment complications or malocclusion. The splint fiber was worn for 30 days and the circumdental arch wiring was for the same. Healing of bone fracture yields good results after 12 weeks. Follow-up care is crucial to monitor for complications, in this study, no post-treatment complications were observed. CONCLUSION: The treatment of pediatric mandibular fractures is complex and requires careful consideration of various factors. Conservative management should be the first choice, with open reduction and internal fixation reserved for specific cases. The use of quartz splint fiber and ligature wire is an effective treatment option for stabilizing the mandible and providing occlusal stability in growing children. A fiber splint along with ligature wire can also be used as an alternative treatment to avoid any adverse effects on the growth and development of the mandible and permanent teeth. A multidisciplinary approach is essential to achieving the best outcomes for pediatric patients with mandibular fractures.

Regulation of lipid synthesis in myelin modulates neural activity and is required for motor learning.

Brain function relies on both rapid electrical communication in neural circuitry and appropriate patterns or synchrony of neural activity. Rapid communication between neurons is facilitated by wrapping nerve axons with insulation by a myelin sheath composed largely of different lipids. Recent evidence has indicated that the extent of myelination of nerve axons can adapt based on neural activity levels and this adaptive myelination is associated with improved learning of motor tasks, suggesting such plasticity may enhance effective learning. In this study, we examined whether another aspect of myelin plasticity-changes in myelin lipid synthesis and composition-may also be associated with motor learning. We combined a motor learning task in mice with in vivo two-photon imaging of neural activity in the primary motor cortex (M1) to distinguish early and late stages of learning and then probed levels of some key myelin lipids using mass spectrometry analysis. Sphingomyelin levels were elevated in the early stage of motor learning while galactosylceramide levels were elevated in the middle and late stages of motor learning, and these changes were correlated across individual mice with both learning performance and neural activity changes. Targeted inhibition of oligodendrocyte-specific galactosyltransferase expression, the enzyme that synthesizes myelin galactosylceramide, impaired motor learning. Our results suggest regulation of myelin lipid composition could be a novel facet of myelin adaptations associated with learning.

Clinical and imaging analysis of 22 cases of supernumerary teeth in the mandibular region.

PURPOSE: This study aimed to describe clinical and imaging analysis of supernumerary teeth in the mandibular region of 22 cases. STUDY DESIGN: Retrospective study METHODS: : This study enrolled patients diagnosed with supernumerary teeth who underwent cone beam computed tomography (CBCT) at Stomatology Hospital of Xi'an Jiaotong University from August 2016 to September 2022. Participants included individuals aged 7-29 years of both genders. The following variables were examined: number of supernumerary teeth, location, shape, direction, length, relationship with adjacent teeth and surrounding anatomical structures, and secondary effects RESULTS: : Out of 236 subjects, 22 (6.02%) were found to have supernumerary teeth in the mandibular region, with a total of 62 teeth identified. The male-to-female ratio was 5:6. Most supernumerary teeth were located in the lingual side of the mandibular region, particularly in the 34-35 tooth area (21.66%), followed by the 44-45 tooth region. The vast majority of supernumerary teeth (96.77%) were impacted, and more than half (51.67%) were located near the mental nerve canal. The average length of the supernumerary teeth was 10.5 mm. While no primary complications were observed, some secondary symptoms were noted, such as the ectopic eruption of adjacent teeth and crowding of permanent teeth. CONCLUSION: The supernumerary teeth in the mandibular area have regional characteristics, which can provide for clinical diagnosis and treatment. CBCT can accurately analyze the location of supernumerary teeth and their secondary effects, and provides the treatment plan on that basis.