Endoscopically-assisted extraction of broken roots or fragments within the mandibular canal: a retrospective case series study.

PURPOSE: To assess the impact of endoscope-assisted fractured roots or fragments extraction within the mandibular canal, along with quantitative sensory testing (QST) alterations in the inferior alveolar nerve (IAN). METHODS: Six patients with lower lip numbness following mandibular third molar extraction were selected. All patients had broken roots or fragments within the mandibular canal that were extracted under real-time endoscopic assistance. Follow-up assessments were conducted on postoperative days 1, 7, and 35, including a standardized QST of the lower lip skin. RESULTS: The average surgical duration was 32.5 min, with the IAN exposed in all cases. Two of the patient exhibited complete recovery of lower lip numbness, three experienced symptom improvement, and one patient remained unaffected 35 days after the surgery. Preoperative QST results showed that the mechanical detection and pain thresholds on the affected side were significantly higher than those on the healthy side, but improved significantly by postoperative day 7 in five patients, and returned to baseline in two patients on day 35. There were no significant differences in the remaining QST parameters. CONCLUSIONS: All endoscopic surgical procedures were successfully completed without any additional postoperative complications. There were no cases of deterioration of IAN injury, and lower lip numbness recovered in the majority of cases. Endoscopy allowed direct visualization and examination of the affected nerve, facilitating a comprehensive analysis of the IAN.

pH sensor based on tilted fiber Bragg grating surface plasmon resonance with a polyaniline reaction deposition film layer.

In this paper, we propose a surface plasmon resonance (SPR) fiber-optic pH sensor combined with a tilted fiber Bragg grating (TFBG) by continuously coating gold and polyaniline (PANI) onto the surface of a TFBG. The micron-scale thickness polyaniline film provides the sensor with good sensitivity, and it achieves accurate measurement of pH values ranging from 2 to 12 by utilizing the pH-responsive mechanism of PANI and the surface plasmon resonance characteristics. Experimental results show that within the 2-12 pH range, the sensitivity of the TFBG surface plasmon resonance pH sensor based on PANI coating is 0.50335 nm/pH, and results demonstrate, a linear correlation coefficient between wavelength and pH value reaching 0.96614. This indicates significant potential for future engineering applications in real-world pH measurement using this sensor.

Association of Helicobacter pylori CagA seropositivity with gastric precancerous lesions: a systematic review and meta-analysis.

The objective of this meta-analysis is to delineate the association between H. pylori CagA serological status and the prevalence of gastric precancerous lesions (GPL). We searched peer-reviewed articles up to October 2023. The extraction of data from the included studies was carried out as well as the quality assessment. Pooled effect sizes were calculated using a random effect model. Thirteen studies met the inclusion criteria, comprising 2728 patients with GPL and 17 612 controls. The aggregate odds ratio (OR) for the association between serum CagA and GPL was 2.74 (95% CI = 2.25-3.32; P  = 0.00; I 2  = 60.4%), irrespective of H. pylori infection status. Within the H. pylori -infected cohort, the OR was 2.25 (95% CI = 1.99-2.56; P  = 0.00; I 2  = 0.0%). Conversely, among the non-infected individuals, the OR was 1.63 (95% CI = 1.04-2.54; P  = 0.038; I 2  = 0.0%). Heterogeneity was explored using subgroup and meta-regression analyses, indicating that the variability between studies likely stemmed from differences in disease classification. Our results demonstrated robustness and negligible publication bias. The meta-analysis underscores a more pronounced association between H. pylori CagA seropositivity and the risk of developing GPL than between seronegativity and the same risk, irrespective of H. pylori infection status at the time. Additionally, the strength of the association was heightened in the presence of an active H. pylori infection. The implications of these findings advocate for the utility of CagA serostatus as a potential biomarker for screening GPL.

Diagnostic and prognostic value of circulating exosomal glypican-1 in pancreatic cancer: a meta-analysis.

BACKGROUND: Pancreatic cancer (PC) is usually detected in the advanced stages. Liquid biopsy has become a revolutionary strategy for cancer diagnosis and prognosis prediction. This study aims to investigate the diagnostic and prognostic value of circulating exosomal glypican-1 (GPC-1) in PC. METHODS: We systematically searched relevant studies. For diagnostic accuracy, pooled sensitivity and specificity and the area under the summary receiver operating characteristic curve (AUC) were calculated. Regarding prognostic value, hazard ratios (HRs) and 95% CIs for overall survival (OS) were summarized by using a random-effects model. RESULTS: We found 8 studies that examined the diagnostic value of circulating exosomal GPC-1 in PC, and 3 studies that investigated its prognostic value. Pooled sensitivity and specificity were 0.88 (95% CI, 0.65-0.97) and 0.86 (95% CI, 0.72-0.94). The AUC was 0.93 (95% CI, 0.90-0.95). Prognostic analysis showed that higher levels of circulating exosomal GPC-1 were associated with poorer OS in PC patients, and the combined HR for OS was 4.59 (random-effects model, 95% CI = 1.17-18.03, P = .022). The results of both studies were robust and neither had publication bias. CONCLUSION: Circulating exosomal GPC-1 may be used as a diagnostic and prognostic biomarker for PC. However, this result needs to be validated by further research using a larger sample size.

Comparison of Composition, Free-Radical-Scavenging Capacity, and Antibiosis of Fresh and Dry Leave Aqueous Extract from Michelia shiluensis.

Numerous plants of medicinal value grow on Hainan Island (China). Given the lack of knowledge on the phytochemical and pharmacological properties of Michelia shiluensis Chun and Y. F. Wu (M. shiluensis), the application of natural antioxidants and antimicrobials in the food industry has attracted increasing interest. This study aimed to compare the chemical composition, free-radical-scavenging capacity, and antibiosis of aqueous extracts of the fresh and dried leaves of M. shiluensis. The aqueous extract of the leaves of M. shiluensis was obtained using steam distillation, and its chemical components were separated and identified via gas chromatography-mass spectrometry (GC-MS). The free-radical-scavenging capacity and antibiosis were determined. Further, 28 and 20 compounds were isolated from the fresh leaf aqueous extract of M. shiluensis (MSFLAE) and dried leaf aqueous extract of M. shiluensis (MSDLAE), respectively. The free-radical-scavenging capacity of MSFLAE and MSDLAE was determined by the 2,2-diphenyl-1 picrylhydrazyl (DPPH) method, which was 43.43% and 38.74%, respectively. The scavenging capacity of MSFLAE and MSDLAE determined by the 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonate (ABTS)) method was 46.90% and 25.99%, respectively. The iron ion reduction capacity of MSFLAE and MSDLAE was determined by the ferric-reducing antioxidant power (FRAP) method as 94.7 and 62.9 µmol Fe2⁺/L, respectively. This indicated that the two leaf aqueous extracts had a certain free-radical-scavenging capacity, and the capacity of MSFLAE was higher than that of MSDLAE. The antibiosis of the two leaf aqueous extracts on the three foodborne pathogenic bacteria was low, but the antimicrobial effects on Gram-positive bacteria were better than those on Gram-negative bacteria. The antibiosis of MSFLAE on Escherichia coli and Staphylococcus aureus was greater than that of MSDLAE. Finally, MSFLAE and MSDLAE both had certain free-radical-scavenging capacities and antibiosis, confirming that the use of this plant in the research and development of natural antioxidants and antibacterial agents was reasonable. Plant aqueous extracts are an essential source of related phytochemistry and have immense pharmacological potential.

Slim the face or not: 3D change of facial soft and hard tissues after third molars extraction: a pilot study.

BACKGROUND: Whether slim the face or not after removed third molars is the concern of some orthodontic treatment candidates. The aim of this article is to explore the volume changes of facial soft and hard tissues after third molars extraction, as well as develop a reproducible clinical protocol to precisely assess facial soft tissue volume change. METHODS: A non-randomized, non-blind, self-controlled pilot study was conducted. 24 adults aged 18-30 had ipsilateral third molars extracted. The body weight change was controlled within 2 kg. Structured light scans were taken under a standardized procedure pre-extraction (T0), three (T1), and six (T2) months post-extraction; CBCTs were taken at T0 and T2. The projection method was proposed to measure the soft tissue volume (STV) and the soft tissue volume change (STVC) by the Geomagic software. The hard tissue volume change (HTVC) was measured in the Dragonfly software. RESULTS: The final sample size is 23, including 5 males (age 26.6 ± 2.5 years) and 18 females (age 27.3 ± 2.5 years). The HTVC was - 2.33 ± 0.46ml on the extraction side. On the extraction side, the STV decreased by 1.396 (95% CI: 0.323-2.470) ml (P < 0.05) at T1, and increased by 1.753 (95% CI: -0.01-3.507) ml (P = 0.05) at T2. T2 and T0 had no difference (P > 0.05). The inter and intra-raters ICC of the projection method was 0.959 and 0.974. There was no correlation between the STVC and HTVC (P > 0.05). CONCLUSIONS: After ipsilateral wisdom teeth extraction, the volume of hard tissue on the extraction side reduces, and the volume of facial soft tissue does not change evidently. However, further research with large sample size is still needed. The STV measurement has excellent repeatability. It can be extended to other interested areas, including forehead, nose, paranasal, upper lip, lower lip and chin, which is meaningful in the field of orthodontics and orthopedics. TRIAL REGISTRATION: ChiCTR, ChiCTR1800018305 (11/09/2018), http://www.chictr.org.cn/showproj.aspx?proj=28868 .

Assessment of Instant Loss of Elbow Flexion in Children with Untreated Gartland IIA Humeral Supracondylar Fractures-A Simulation Study with Lateral Elbow Radiographs.

OBJECTIVE: The suitability of in situ cast fixation for treating Gartland IIA humeral supracondylar fractures has remained controversial due to concerns regarding loss of elbow flexion. This study aimed to assess the instant loss of elbow flexion after Gartland IIA humeral supracondylar fractures based on the relationship between the anterior marginal line of the humerus and capitellum in the lateral view. METHODS: This simulation study was conducted with normal radiographs using Adobe Photoshop 14.0, followed by verification using clinical cases. Standard lateral views of normal elbows of children were collected from January 2008 to February 2020. Adobe Photoshop was used to simulate Gartland IIA supracondylar fractures with different degrees of angulation in the sagittal plane. A formula was deduced to assess flexion loss, and this method was verified in three cases. The data were grouped by age, and the relationship between elbow flexion loss and age, as well as the angulation of the fracture, was analyzed using a one-way or multivariate ANOVA. RESULTS: There was a flexion loss of 19° (11-30°) when the anterior margin line of the humerus was tangential to the capitellum. This loss increased with age at injury (r = 0.731, P = 0.000). Moreover, the difference in angulation in the sagittal plane also influenced the extent of elbow flexion loss (r = -0.739, P = 0.000). The more horizontal the fracture line in the lateral view, the greater the loss of elbow flexion. CONCLUSION: Instant elbow flexion loss after Gartland IIA humeral supracondylar fractures increases with age at the time of injury and decreases with angulation in the sagittal plane. When the anterior margin of the humerus is tangential to the capitellum, there will be an average loss of 19° in elbow flexion. These findings provide a quantitative reference for clinical decision-making in the treatment of Gartland IIA supracondylar fractures.

Endoscopic visualization of the inferior alveolar nerve associated with somatosensory changes after impacted mandibular third molar extraction.

The aim of this study is to assess the relationship between somatosensory functional changes and inferior alveolar nerve (IAN) exposure after impacted mandibular third molars (M3M) removal. We recruited 35 patients who underwent impacted M3M extraction near the IAN. The M3Ms were extracted by combined endoscopy, piezosurgery, and contra-angle high-speed turbine handpiece. All IAN canal perforations and exposed regions were recorded and measured by endoscopy after extraction and on cone-beam computed tomography (CBCT) images before extraction. The patients were followed up 1, 7, and 35 days after surgery. A standardized quantitative sensory testing (QST) battery was performed on the lower lip skin. All of 35 cases had exposed IAN on CBCT images, 5 of which had no exposed IAN under endoscopy. For the other 30 cases, the endoscopy-measured IAN length and width were shorter than the CBCT measurements (P < 0.001). The warm and mechanical detection thresholds (MDT) on the operation side were significantly higher than the contralateral side after surgery (P < 0.05). Thermal sensory limen, MDT, and cold pain threshold were strongly correlated with the exposed IAN length and MDT also with the exposed IAN width one day after surgery. In conclusion, it was found that not all exposed IAN in CBCT images were real exposure after surgery. The intraoperative exposed IAN endoscopic measurements were smaller than by CBCT and strongly correlated with some QST parameters.

Transcriptome Analysis Revealing the Interaction of Abscisic Acid and Cell Wall Modifications during the Flower Opening and Closing Process of Nymphaea lotus.

As a tropical flower, Nymphaea lotus is a typical night-blooming waterlily used in water gardening. Its petals are rich in aromatic substances that can be used to extract essential oils and as flower tea. However, the short life of the flower seriously affects the development of its cut flowers. At present, neither the mechanism behind the night-opening waterlily flower's opening and closing nor the difference between day-opening and night-opening waterlily flowers' opening and closing mechanisms are clear. In this study, endogenous hormone contents of closed (CP) and open (OP) petals were measured, and transcriptome analysis of CP and OP petals was carried out to determine the signal transduction pathway and metabolic pathway that affect flower opening and closing. ABA and cell wall modification were selected as the most significant factors regulating flowering. We used qRT-PCR to identify the genes involved in the regulation of flower opening in waterlilies. Finally, by comparing the related pathways with those of the diurnal type, the obvious difference between them was found to be their hormonal regulation pathways. In conclusion, the endogenous ABA hormone may interact with the cell wall modification pathway to induce the flowering of N. lotus. Our data provide a new direction for the discovery of key factors regulating the flower opening and closing of N. lotus and provide basic theoretical guidance for future horticultural applications.

Rotation of both X- and Y-axes is a predictive confounder of ulnar nerve injury and open reduction in pediatric lateral flexion supracondylar humeral fractures: A retrospective cohort study.

Background: Rotation of the distal fragment often occurs in flexion-type supracondylar humerus fractures (SCHFs), potentially leading to ulnar nerve injury (UNI) and open reduction. We analyzed the correlation between the rotations and UNI or open reduction and then assessed the risk factors associated with these rotations. Methods: Data of Wilkins type III lateral flexion SCHFs were collected over a 10-year time period (1 January 2012 to 31 December 2021) in Children's Hospital of Fudan University Anhui Hospital. We defined the rotation of the distal fragment on the coordinate axis as two types, IIIA (X-axis rotation) and IIIB (the rotation of both X- and Y-axes) on X-ray radiography. Demographic data, the incidence of the two-type rotation, odds ratios (ORs) of UNI and open reduction, and risk factors of the rotation of both X- and Y-axes were analyzed. Results: Totally, 152 patients were found (50 with IIIA vs. 102 IIIB). The UNI rate was 13%, and the open reduction rate was 22%. The UNI rate of the IIIB was five-fold higher than that of the IIIA [OR, 5.143; 95% confidence interval (CI), 1.414-23.125; p = 0.019], and the open reduction rate of the IIIB was nearly five-fold higher than that of the IIIA (OR, 4.729, 95%CI, 1.584-14.495; p = 0.003). In these two types, patients with UNI had a higher risk of open reduction than those without UNI (OR, 9.816; 95%CI, 3.503-27.508; p = 0.001). In the multiple regression analysis, a high level of fracture was identified as a risk factor for the rotation of both X- and Y-axes. Conclusion: Type IIIB lateral flexion-type SCHFs have higher rates of UNI and open reduction, and a high level of fracture is a risk factor associated with this type.

Bone regeneration using titanium plate stabilization for the treatment of peri-implant bone defects: A retrospective radiologic pilot study.

AIM: To 3-dimensional radiographically assess the effect of titanium plate in guided bone regeneration (GBR) for the treatment of peri-implant ridge defects in esthetic zone. MATERIAL AND METHODS: Nineteen patients with buccal peri-implant defects in the maxillary esthetic zone were treated with GBR using xenograft, autogenous bone, and collagen membrane. Subjects were divided into two groups: control (conventional GBR, 10 patients with 16 implants) and test (GBR with an adjunctive titanium plate; nine patients with 15 implants). Cone-beam computed tomography (CBCT) images obtained immediately after and 5-7 months following GBR were used to assess buccal crestal bone level (BBL) and buccal bone thickness (BBT) at different implant levels. RESULTS: Thirty-one implants in 19 patients were evaluated. Titanium plate exposure occurred in three cases (33.33%) of the test group. After 5-7 months, the mean BBL was located 1.48 ± 0.71 mm coronal to the platform in the test group and 0.90 ± 3.03 mm coronal to the platform in the control group (p = 0.03). The mean over all BBT (BBT-M) was 4.16 ± 0.48 mm in the test group and 2.38 ± 0.97 mm in the control group (p < 0.01). More resorption occurred in the control group than in the test group regarding mean BBL (3.00 ± 3.11 mm vs. 0.78 ± 0.79 mm, respectively; p = 0.04), BBT-M change (1.87 ± 1.59 mm vs. 0.56 ± 0.33 mm, respectively; p = 0.02), and percentage change in BBT-M (40.69 ± 24.01% vs. 11.53 ± 5.86%, respectively; p < 0.01). CONCLUSION: In the short-term, titanium plate-enhanced GBR maintained ridge dimensions better than conventional GBR did.

Retrospective Comparison of Outcomes Between Closed and Open Reduction for Developmental Dysplasia of the Hip in Children Aged 6-24 Months.

Purpose: We aimed to compare the outcomes between closed reduction (CR) and open reduction (OR) in children aged 6-24 months with developmental dysplasia of the hip (DDH) who could be reduced safely and stably by the closed reduction operation. Methods: We retrospectively reviewed the medical records of 77 patients who underwent CR or OR for DDH. Fifty-one patients (56 hips) underwent CR, 26 (29 hips) underwent OR. The demographic data, International Hip Dysplasia Institute classification and acetabular index (AI) before reduction and the centre-edge angle (CEA), AI, Alsberg angle (AA), Reimer's migration index (RMI), and height-to-width index (HWI) of the epiphysis were compared between two groups at the final follow-up. The percentage of coxa magna > 15% of the normal side and AA > 81° were calculated. Results: At the final follow-up, the mean AA in the CR and OR groups were 77.66° (60°-89°) and 81.97° (73°-91°) (p = 0.001), respectively, there were 32.14% and 58.62% of the hips with an AA > 81° (p = 0.019). The frequency of coxa magna > 15% of the normal side was higher in the OR group (60.9%) than in the CR group (6.5%) (p < 0.001). There was no difference in the improvement of AI, CEA, HWI, and RMI. Conclusion: In children aged 6-24 months with DDH, if a stable and safe CR can be obtained but with medial joint space up to 6mm, CR should be attempted first.

Morpho-histology, endogenous hormone dynamics, and transcriptome profiling in Dacrydium pectinatum during female cone development.

Dacrydium pectinatum de Laubenfels is a perennial dioeciously gymnosperm species dominant in tropical montane rain forests. Due to deforestation, natural disasters, long infancy, and poor natural regeneration ability, the population of this species has been significantly reduced and listed as an endangered protected plant. To better understand the female cone development in D. pectinatum, we examined the morphological and anatomical changes, analyzed the endogenous hormone dynamics, and profiled gene expression. The female reproductive structures were first observed in January. The morpho-histological observations suggest that the development of the D. pectinatum megaspore can be largely divided into six stages: early flower bud differentiation, bract primordium differentiation, ovule primordium differentiation, dormancy, ovule maturity, and seed maturity. The levels of gibberellins (GA), auxin (IAA), abscisic acid (ABA), and cytokinin (CTK) fluctuate during the process of female cone development. The female cones of D. pectinatum need to maintain a low level of GA3-IAA-ABA steady state to promote seed germination. The first transcriptome database for female D. pectinatum was generated, revealing 310,621 unigenes. Differential expression analyses revealed several floral (MADS2, AGL62, and LFY) and hormone biosynthesis and signal transduction (CKX, KO, KAO, ABA4, ACO, etc.) genes that could be critical for female cone development. Our study provides new insights into the cone development in D. pectinatum and the foundation for female cone induction with hormones.

Predictive factors for open reduction of flexion-type supracondylar fracture of humerus in children.

OBJECTIVE: The incidence of open reduction and internal fixation (ORIF) in flexion-type supracondylar humerus fractures (SCHF) in children is significantly higher than that of extension-type fractures. This study aimed to identify risk factors for ORIF in flexion-type SCHF. METHODS: One hundred seventy-one patients with Wilkins type III flexion-type SCHF from January 2012 to December 2021 were retrospectively enrolled in a tertiary paediatric hospital. Patients were divided into ORIF group versus closed reduction and internal fixation (CRIF) group. Then, patients data of age, sex, injury side, obesity, deviation of displacement, fracture level, rotation, nerve injury, and delay from injury to surgery were reviewed. Univariate analysis and multivariate logistic regression were used to identify independent risk factors and odds ratios (OR) of ORIF. RESULTS: Overall, 171 children with type III flexion-type SCHF were analyzed (average aged 7.9 ± 2.8 years). Displacement was lateral in 151 cases, medial in 20. 20 cases had combined ulnar nerve injury. The failed closed reduction rate was 20%. Univariate analysis indicated age, distal fracture fragment rotation, and ulnar nerve injury were significantly associated with ORIF. (P = 0.047, P = 0.009, and P = 0.001, respectively). Multivariate logistic regression analysis showed that distal fracture fragment rotation (OR, 3.3; 95%CI:1.1-9.5; P = 0.028) and ulnar nerve injury (OR, 6.4; 95%CI:2.3-18.3; P = 0.001) were independent risk factors; however, the age was not an independent one (OR, 1.5; 95%CI:0.6-3.5; P = 0.397) for ORIF in the Wilkins type III flexion-type SCHF. CONCLUSION: Distal fracture fragment malrotation on initial x-rays and ulnar nerve injury were significant risk factors for ORIF in Wilkins type III flexion-type SCHF. Surgeons should prepare tourniquets or other open reduction instruments when treating these types of fractures. LEVEL OF EVIDENCE: Level IV.

The Integrity of Cartilage Hinge in Song 2/3 Lateral Humeral Condylar Fractures in Children: A Retrospective Radiological Study in Two Centers.

OBJECTIVE: For pediatric lateral condylar fractures (LCFs) of the humerus, it is often hard to determine the stability of the fracture based on the Song classification, especially for those categorized as Song stages 2 and 3. This study aims to define the characteristics of cartilage injury and assess the stability of LCFs classified as Song stages 2 and 3 on post-traumatic magnetic resonance imaging (MRI). METHODS: This was a retrospective study based on imaging data, conducted with a short follow-up period. From January 2016 to May 2019, data of all patients with Song 2 and Song 3 LCFs treated at two institutions were collected. Based on the inclusion criteria, a total of 62 patients with Song stage 2/3 LCF were included. All radiographs were selected for observation and classification for comparison by two observers, both experienced pediatric orthopedic surgeons. MRIs scans for comparison were analyzed in three consecutive coronal sections and cross-sections. Patients were treated conservatively with casting or surgically with closed reduction and percutaneous pinning (CRPP). RESULTS: Altogether 62 cases between 1.5 to 9 years old were included. Reliability analysis revealed poor, moderate, or good agreement between the two observers (range, 0.149-0.633). Both observers showed moderate or good consistency (range, 0.413-0.611). Among the 62 patients diagnosed with Song stages 2 and 3 fractures on initial radiographs, only two patients (3%) had complete fractures with complete disruption of the cartilage hinge as seen on MRI. The hinge was generally located in the posterior-inferior region of the distal humeral cartilage as indicated on MRI. There was no significant difference between Song stages 2 and 3 with regard to ratio of hinge to total values in any cross-sections, nor was there any significant difference in the completeness of the coronal sections (P > 0.05). Of the 62 patients treated, 50 were managed conservatively with casting and 12 underwent CRPP. Forty-nine of the remaining 60 patients (97%) with incomplete fractures were managed conservatively, while the remaining 11 patients were managed with CRPP. All patients with incomplete fractures showed bone healing and no evidence of lateral condyle displacement on follow-up radiographs. CONCLUSIONS: The Song stage 2 or 3 classification is not entirely accurate and is inadequate at guiding treatment outcomes. The cartilage hinge was most likely located posteroinferiorly within the distal humeral epiphysis. According to our findings, conservative treatment with an effective cast or splint may be sufficient for bone healing in case of incomplete cartilage fractures.

A three-in-one alveolar process reconstruction protocol for maxillary molar sites with severe residual bone height deficiency: A proof-of-concept pilot study.

BACKGROUND: Implant placement in maxillary molar sites with severe height deficiency often requires multiple surgeries, which was time-consuming, invasive, and subject to serious postoperative complications. PURPOSE: To introduce and assess a three-in-one technique (extraction, alveolar ridge preservation [ARP], and sinus elevation) for augmenting deficiency maxillary molar alveolar ridges. MATERIAL AND METHODS: Fourteen patients with severe posterior maxillary ridge height deficiency underwent extraction, sinus elevation via an intrasocket window and ARP using sticky bone and then covered with acellular dermal matrix (ADM). Primary closure was intentionally not obtained. Cone-beam computed tomography and periapical radiography were used to measure dimensional ridge changes over time. Bone biopsies were taken at implant placement 7-21 months after surgery, which proceeded without additional grafting. Peri-implant soft tissue was assessed after 8-12 months of functional loading. RESULTS: Maxillary molar sites (13 first molars, 1 second molar) with a mean sinus floor height of 1.73 ± 0.86 mm and mean buccal plate thickness of 1.62 ± 1.15 mm were elevated and grafted. Immediately after surgery, the mean sinus floor height was 14.03 ± 1.97 mm and the alveolar thickness at virtual implant platform level was 12.99 ± 1.88 mm. After 5-9 months healing, those measurements decreased by 2.45 ± 1.73 mm (p = 0.000) and 3.88 ± 3.95 mm (p = 0.006), respectively. Healed ridges were composed of 18.74% ± 4.34% mean vital bone and 19.08% ± 9.10% mean residual graft. After 8-12 months of functional loading, the peri-implant tissue appeared healthy, and there was a mean marginal bone loss of 0.12 ± 0.11 mm. CONCLUSIONS: For maxillary first molar sites with severe sinus floor height deficiency, this minimally invasive three-in-one treatment allows for uncomplicated implant placement and short-term functional stability.

Cryoablation treatment of oral and maxillofacial tumors: Five case reports.

Oral and maxillofacial anatomy and function are important and complex. They are involved in facial expressions, chewing, language, breathing, and other functions. It is therefore important to choose the optimal treatment plan for oral and maxillofacial tumors. For patients with who cannot tolerate surgery or who refuse surgery or radiotherapy can be treated with cryoablation. Cryoablation can maintain local tissue integrity and organ function and protect facial integrity. It is a repeatable treatment that, if necessary, can be followed by traditional antineoplastic therapies. This study introduces five cases with severe basic diseases who cannot tolerate or have refused surgery or radiotherapy. The patients were diagnosed as having oral and maxillofacial tumors. These patients experienced painful local swelling or breaking of the tumor. All patients received cryoablation combined with other treatments. Local control of the tumors and improved function and quality of life were achieved. In clinical work, for patients with severe basic diseases who cannot tolerate or refuse surgery or radiotherapy, cryoablation has unique advantages, and this approach is expected to become a widely used treatment for oral and maxillofacial tumors.

Analysis of the location and trajectory of the Kirschner wires in the fixation of extension-type supracondylar fracture of the humerus by 3D computational simulation.

BACKGROUND: Closed reduction and percutaneous pinning is still a preference for the treatment of supracondylar humerus fractures in children. However, no reports have shown the pin trajectory and the characteristics of the entry point so far. So we established a computational simulation model of the elbow to observe the trajectory of pinning for supracondylar humerus fractures. METHODS: We reconstructed an adult elbow computationally and simulated pin placement through lateral and medial pinning. Pin trajectories were traced after placement and after the addition of the skin profile; the relative entry points of the pins were determined. We used the center of the dorsal olecranon inflection as an anatomic reference for the entry points of lateral pinning. Four quadrants were established based on the center of the dorsal olecranon inflection: upper medial quadrant, upper lateral quadrant, lower medial quadrant, and lower lateral quadrant (LLQ). RESULTS: The maximum angle of pinning through the lateral column was 64° ± 3°. The minimum angles of pinning through the lateral column and middle column were 37° ± 3° and 20° ± 2°, respectively. The range of safe angle pinning through the medial column was between 18° ± 2° and 57° ± 3° to avoid penetration of the olecranon fossa and the cortex of the medial column. The entry points of lateral pinning were within the lateral half of the LLQ, and the lateral one-third of the LLQ contained all entry points of the pins through the lateral column and minor points of the pins through the middle column. The exit points of the medial pinning were within the lateral fringe of the metaphyseal-diaphyseal junction region; entering from the inferior two-thirds of the medial epicondyle could lead to the exit points in the proximal half of the metaphyseal-diaphyseal junction region laterally. DISCUSSION: For lateral pinning, the entry points would be within the lateral half of the LLQ. For the pins through the lateral column, the entry points should be within the lateral one-third of the LLQ. For medial pinning, entering from the inferior two-thirds of the medial epicondyle would lead to a more proximal exit.