Effects of sleep deprivation on pain-related factors in the temporomandibular joint.

BACKGROUND: The objective of this study was to investigate the effects of experimental sleep deprivation (SD) on the temporomandibular joint (TMJ) in rats by examining pain-related factors and to determine the possible involvement of estrogen and NF (nuclear factor) κB signaling in the TMJ synovial membrane. METHODS: The influence of SD, conducted in rats using the modified multiple platform method, was estimated by observing behavioral manifestations and examining changes in serum hormone levels. The morphologic changes of synovial tissue were observed with light microscopy and the serum levels of estrogen were measured by radioimmunoassay. Activation of NF-κB in the synovial membrane was examined using an immunofluorescence technique, and the expression levels of interleukin (IL) 1ß, IL-6, tumor necrosis factor α, cyclooxygenase 2, and inducible nitric oxide synthase were measured with real-time polymerase chain reaction. RESULTS: The SD group showed evidence of elevated anxiety and stress, and increased plasma levels of estradiol compared with the control group. The activity of NF-κB was significantly enhanced and translocation of NF-κB p65 was evident in the synovial membrane after SD. The expression of pain-related factors IL-1ß, IL-6, cyclooxygenase-2, tumor necrosis factor α, and inducible nitric oxide synthase in the synovial membrane significantly increased after SD. CONCLUSIONS: These results indicate that SD increases serum levels of estrogen and induces alterations in pain-related factors in the TMJ. The NF-κB pathway has been associated with the regulation of these inflammatory cytokines and plays an important role in temporomandibular disorders.

Role of prognostic gene DKK1 in oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is one of the most common squamous cell carcinomas of the head and neck. The morbidity and mortality rates of OSCC have increased in recent years. However, the pathogenesis of this disease remains unknown. The present study aimed to identify predictive biomarkers and therapeutic targets for OSCC. Bioinformatics screening of differentially expressed genes in OSCC was performed based on data from The Cancer Genome Atlas and Gene Expression Omnibus databases. Dickkopf Wnt signaling pathway inhibitor 1 (DKK1) was identified to be associated with survival, tumor immunity and DNA repair in OSCC. Furthermore, the effects of DKK1 were evaluated by the knockdown of DKK1 in two OSCC cell lines. The proliferation, clonogenicity, migration and invasion of the cells were assessed in vitro using Cell Counting Kit-8, colony formation, wound healing and Transwell assays, respectively, and were found to be inhibited by DKK1 knockdown. The present study suggests that DKK1 may be used in the prognosis of patients with OSCC and that targeting DKK1 is a potential strategy for OSCC therapy.

Low-intensity ultrasound accelerates mandibular implant bone integration in dogs with mandibular osteoradionecrosis.

BACKGROUND: To investigate whether low-intensity ultrasound accelerates healing in bone tissues close to dental implants with osteoradionecrosis (ORN) of the mandible and is suitable for development as a therapy in patients with dental implants receiving radiotherapy. MATERIALS AND METHODS: Dog models of radiative bone injury surrounding dental implants in both sides of mandible were established by four treatment methods of radiotherapy, each 15Gy. After radiative treatment, antibiotics were administered and the left injury was treated with ultrasound and the right with debridement. Measures for evaluation included spiral computed tomography (SCT), Micro-CT, microvessel density, and pull-out experiment, and data were collected and analyzed. RESULTS: After 4months of radiotherapy, both sides of mandible displayed preclinic symptom of radiative osteonecrosis. Microvessel density of the side treated by ultrasound was 6.2152±0.6508 and that of the debridement side was 3.8490±0.8954 (P<0.05). Micro-CT results showed that bone volume fraction of trabecula, thickness of trabecula, trabecula spacing, ratio of bone surface area to bone volume, and trabecula number of the ultrasound-treated mandible were 0.3605±0.0337, 0.0287±0.0045, 0.0369±0.0073, 71.6124±14.1649, and 7.2915±1.4937, whereas those of the debridement side were 0.1779±0.0178, 0.0151±0.0021, 0.6623±0.1125, 33.2686±5.949, and 5.0689±0.5028, respectively; statistical significance was observed (P<0.05). Pull-out experiment suggested that pull-out strength of the ultrasound-treated side was 0.5793±0.1066 whereas that of the debridement side was 0.2980±0.0243, representing a statistical significance (P<0.05). CONCLUSIONS: Low-intensity ultrasound can accelerate the healing of bone tissues surrounding dental implants in osteoradionecrosis of the mandible animals.

Psychological stress may contribute to temporomandibular joint disorder in rats.

BACKGROUND: Psychological stress is considered a possible pathogenic factor for temporomandibular joint disorders (TMJD), but few reports have supplied direct evidence. This study was designed to observe the effects of psychological stress on the masticatory muscles and condylar processes in rats to directly investigate the role of psychological stress in TMJD morbidity. MATERIALS AND METHODS: A well-established rat communication box model was used to compare the myoelectric profiles of temporal and masseter muscles and condylar microstructure among rats in a control group, a psychological stress group (PS group), and a diazepam (anxiolytic agent) injection group (PS + DI group). Reverse-transcription polymerase chain reaction was also used to analyze the substance P mRNA and calcitonin gene-related peptide mRNA levels expressed in condylar cartilages during different phases of psychological stress. RESULTS: At 1, 3, and 5 wk, both temporal and masseter muscles in the PS group exhibited a significantly higher electrical potential in relaxation than those in the control group (P < 0.01). The electrical potential during contraction of the temporal and masseter muscles was higher than in the relaxation or control group at 1, 3, and 5 wk (P < 0.01). Scanning electron microscopy demonstrated pathologic changes in condylar processes in the PS group that were not observed in the PS + DI group. Reverse-transcription polymerase chain reaction also showed that the expression of substance P and calcitonin gene-related peptide in rat temporomandibular joint was upregulated during each phase of the psychological stress (P < 0.05). CONCLUSIONS: Psychological stress may play an important role in the formation of TMJD.

Relationship between implantation of missing anterior teeth and oral health-related quality of life.

PURPOSE: The aim of the present study was to investigate the relationship between anterior teeth implantation and oral health-related quality of life (OHRQoL). METHODS: Participants completed the Chinese version of the Oral Health Impact Profile-14 (OHIP-14) prior to implantation and at 6 months following crown restoration. Participant demographic information was recorded. Six months following implant crown restoration, participants were asked to self-assess their overall oral health and implant restoration. A Kruskal-Wallis test and Spearman correlation test were used for statistical analyses. A p value <0.05 was considered statistically significant. RESULTS: A total of 238 patients (133 women and 105 men) completed the study. OHP-14 scores were negatively correlated with self-assessment of both overall oral health (r = -0.788, p < 0.001) and implant restoration (r = -0.739, p < 0.001) after implant crown restoration. There were no significant differences between qualitative reasons for dissatisfaction or between quantity of reasons given for dissatisfaction (p = 0.845). Six months following crown restoration, the overall OHIP-14 scores and the four common factors (disability, psychological discomfort, functional limitation, pain, and discomfort) decreased significantly compared to preimplantation scores (p < 0.001). From the paired differences between genders before and after implantation, significant differences were observed in overall quality (p = 0.044) and disability (p = 0.029). Patients with a higher education level scored significantly higher on overall quality of life (p = 0.031) and psychological discomfort (p = 0.002) following crown restoration. CONCLUSIONS: Our findings indicate that the implantation of anterior missing teeth could significantly improve patient OHRQoL. Gender and education level were shown to affect implantation results.

Ultrasonic treatment of canine ORNM.

PURPOSE: To investigate the effect of low-intensity ultrasound on mandibular osteoradionecrosis. MATERIALS AND METHODS: Using a canine model, radiotherapy was delivered to the mandible at doses of 25 and 28 Gy. The microstructure of the mandible and changes in microvascular density in the low-intensity ultrasound treatment (group A) and nontreatment (group B) groups were determined and compared with those of the control group. RESULTS: At a single dose of 28 Gy, the canines developed epilation of the mandibular skin, ulcers, and small pieces of oral sequestered material. The microvascular density in group A was significantly greater than that in group B (P<.05). Most osteocytes in group B had disappeared, with atrophy of the cancellous bone trabeculae. In contrast, in group A, a substantial amount of bone had been formed, with increasing amounts of bone trabeculae and a large number of osteoblasts. CONCLUSIONS: Low-intensity ultrasound effectively improves the healing of irradiated bone.

The influence of psychological stress on the rat temporomandibular joint with the application of countermeasures.

OBJECTIVE: This study aimed to provide an experimental theoretical basis for the treatment of temporomandibular disorders by observing the effects of psychological stress and countermeasures on the rat temporomandibular joint (TMJ). METHODS: Rats were exposed to psychological stress via a communication box and the lateral pterygoid muscle and TMJ were observed with transmission electron microscopy and scanning electron microscopy. Furthermore, the expression of interleukin-1 and tumor necrosis factor-α was assessed in control animals and psychological stress (PS) and stress with diazepam (PS+DI) groups. RESULTS: Transmission electron microscopy of the lateral pterygoid muscle fibers in the PS showed vacuolar changes in the mitochondria, loss of cristae, and reduced matrix density to variable degrees after 1, 3, and 5 wk of stress. After 5 wk stress+recovery, the cristae and matrix were normal in the PS and PS+DI groups. Scanning electron microscopy of PS rats showed some synovial membranes were detached from the surface of the articular disc after 1 wk. After 3 wk, collagen fibers appeared to have wider waves and worn strips changing in size on the articular disc; after 5 wk, the distribution of collagen fibers was distorted. In PS+recovery and PS+DI rats, no obvious changes were observed on the surface of the articular disc after 1 to 5 wk stress. In PS rats, interleukin-1 and tumor necrosis factor-α expression increased significantly but was at control levels in the PS+DI and PS+recovery groups. CONCLUSION: Counteracting psychological stress can antagonize its effects on the TMJ and provide a reference for the treatment of stress-related temporomandibular disorders.

Primary Exploration of the Clinical Application of 3D-Printed Complete Dentures.

PURPOSE: To explore the applications of 3D scanning and 3D printing techniques in the restorative treatment of edentulous patients. MATERIALS AND METHODS: A total of 30 edentulous patients (Atwood classes 1 to 4) who visited The 960th Hospital of the People's Liberation Army, Jinan, China, from March 1, 2018 to May 1, 2020 were selected, and the patients were randomly divided into two groups: a traditional complete denture group (group A) and a 3D-printed complete denture group (group B). Each group comprised 15 patients. In group A, the traditional method was used to fabricate complete dentures. In group B, 3D scanning, computer-aided design (CAD), 3D printing, and the duplicate denture technique were used to fabricate the dentures. A single-blinded method was used. Patient satisfaction was measured with a 0-10 visual analog scale (VAS) at four time points: immediately and 1 month, 3 months, and 6 months after denture delivery. SPSS version 22.0 software was used to analyze the data. RESULTS: The ability to speak, ability to chew, and comfort in the two groups gradually improved at the first three time points. VAS scores increased to a satisfactory level after 3 months. The esthetics and stability of the two groups were scored high after the initial delivery. The VAS scores of the two groups regarding esthetics, ability to speak, ability to chew, stability, and comfort were not significantly different (P > .05) at any time point. The number of visits in the 3D-printed complete denture group were significantly decreased in comparison to the traditional group. CONCLUSION: The use of 3D printing for manufacturing complete dentures can rapidly restore edentulous patients and meet patient demands regarding esthetics and function.

ATP Promotes Oral Squamous Cell Carcinoma Cell Invasion and Migration by Activating the PI3K/AKT Pathway via the P2Y2-Src-EGFR Axis.

Oral cancer is one of the most common malignancies of the head and neck, and approximately 90% of oral cancers are oral squamous cell carcinomas (OSCCs). The purinergic P2Y2 receptor is upregulated in breast cancer, pancreatic cancer, colorectal cancer, and liver cancer, but its role in OSCC is still unclear. Here, we examined the effects of P2Y2 on the invasion and migration of oral cancer cells (SCC15 and CAL27). The BALB/c mouse model was used to observe the involvement of P2Y2 with tumors in vivo. P2Y2, Src, and EGFR are highly expressed in OSCC tissues and cell lines. Stimulation with ATP significantly enhanced cell invasion and migration in oral cancer cells, and enhanced the activity of Src and EGFR protein kinases, which is mediated by the PI3K/AKT signaling pathway. P2Y2 knockdown attenuated the above ATP-driven events in vitro and in vivo. The PI3K/AKT signaling pathway was blocked by Src or EGFR inhibitor. Extracellular ATP activates the PI3K/AKT pathway through the P2Y2-Src-EGFR axis to promote OSCC invasion and migration, and thus, P2Y2 may be a potential novel target for antimetastasis therapy.

Low-intensity pulsed ultrasound promotes aggrecan expression via ZNT-9 in temporomandibular joint chondrocytes.

Temporomandibular joint osteoarthritis (TMJ-OA) is one of the most common joint diseases. It causes severe pain and poor quality of life. One key feature of TMJ-OA is degeneration of the chondrocyte extracellular matrix (ECM). Low-intensity pulsed ultrasound (LIPUS) can promote the synthesis of ECM in cartilage. However, the exact mechanism is still unclear. We aimed to explore the mechanism by which LIPUS promotes the expression of aggrecan in chondrocytes. In vivo, TMJ-OA rats established by unilateral occlusal trauma were treated with LIPUS. In our RNA sequencing data, we found that ADAMTS-8 was downregulated by LIPUS. In vitro, chondrocytes were treated with IL-1ß and LIPUS. Among Zn2+ exporters, ZNT-9 was specifically upregulated by LIPUS. Activation of ZNT-9 by LIPUS downregulated ECM-degrading enzymes (MMP-3, ADAMTS-5 and ADAMTS-8) and metal regulatory transcription factor-1 (MTF-1) and upregulated aggrecan in chondrocytes. Furthermore, ZNT-9 knockdown caused upregulation of MMP-3, ADAMTS-5, ADAMTS-8 and MTF-1, with concomitant downregulation of aggrecan. The opposite results were obtained after ZNT-9 overexpression. Our experiments demonstrate that LIPUS protects chondrocytes by increasing the expression of aggrecan through ZNT-9.

Low-Intensity Pulsed Ultrasound Modulates RhoA/ROCK Signaling of Rat Mandibular Bone Marrow Mesenchymal Stem Cells to Rescue Their Damaged Cytoskeletal Organization and Cell Biological Function Induced by Radiation.

Osteoradionecrosis of the jaw (ORNJ) is an infrequent yet potentially devastating complication of head and neck radiation therapy. Low-intensity pulsed ultrasound (LIPUS) has been widely accepted as a promising method for the successful management of ORNJ, but the mechanism remains unclear. In this study, the effects of LIPUS on cytoskeletal reorganization, cell viability, and osteogenic differentiation capacity of rat mandible-derived bone marrow mesenchymal stem cells (M-BMMSCs) induced by radiation were determined by immunofluorescence staining, CCK-8 cell proliferation assay, quantification of alkaline phosphatase (ALP) activity, alizarin red staining, and real-time RT-PCR, respectively. Moreover, the involvement of the RhoA/ROCK signaling pathway underlying this process was investigated via western blot analysis. We found that radiation induced significant damage to the cytoskeleton, cell viability, and osteogenic differentiation capacity of M-BMMSCs and downregulated their expression of RhoA, ROCK, and vinculin while increasing FAK expression. LIPUS treatment effectively rescued the disordered cytoskeleton and redistributed vinculin. Furthermore, the cell viability and osteogenic differentiation capacity were also significantly recovered. More importantly, it could reverse the aberrant expression of the key molecules induced by radiation. Inhibition of RhoA/ROCK signaling remarkably aggravated the inhibitory effect of radiation and attenuated the therapeutic effect of LIPUS. In the light of these findings, the RhoA/ROCK signaling pathway might be a promising target for modifying the therapeutic effect of LIPUS on osteoradionecrosis.

Effect of low-intensity pulsed ultrasound on the biological behaviors of bone marrow mesenchymal stem cells on titanium with different surface topographies.

The use of low-intensity pulsed ultrasound (LIPUS) is a promising approach to promote osteogenesis. However, few studies have reported the influence of this technique on the osseointegration of endosseous implants, especially regarding different implant topographies. We focused on how the initial interaction between cells and the titanium surface is enhanced by LIPUS and the potential regulatory mechanisms. The bone marrow mesenchymal stem cells (BMSCs) of rats were cultured on two types of titanium surfaces (polished surface, Flat and large grain blast acid etched, SLA) under LIPUS stimulation or control conditions. The cell proliferation on the implant surfaces was significantly promoted by LIPUS, which stimulated the increase in the number of microfilaments, pseudopodia formed and extracellular matrix mineralization nodules compared with those in the control group. The expression of osteogenesis-related genes, including OPN, OCN, BMP-2, ALP, Runx2 and Col-1, were up-regulated on all the surfaces by LIPUS stimulation. Our findings suggest that LIPUS enhances osteoblast differentiation from BMSCs on titanium surfaces. The use of LIPUS might be a potential adjuvant treatment to improve the osseointegration process.

RNA sequencing reveals target genes of temporomandibular joint osteoarthritis in rats after the treatment of low-intensity pulsed ultrasound.

PURPOSE: To explore the potential molecular mechanism of low-intensity pulsed ultrasound (LIPUS) in the treatment of temporomandibular joint osteoarthritis (TMJ-OA), and identify the target genes for therapy of TMJ-OA. METHODS: Rat TMJ-OA was induced by unilateral occlusal trauma (UOT). At 8 weeks, the experimental group rats were treated by LIPUS for 4 weeks (5 days every week). The cartilage was examined by histological techniques. Gene expression profile in control, placebo and LIPUS-treated group were measured by RNA sequencing (RNA-Seq). Gene oncology (GO) and kyoto encyclopedia of genes and genomes (KEGG) annotated were performed and ten differentially expressed genes (DEGs) were further validated in another individual by quantitative real-time polymerase chain reaction (qRT-PCR). Per-2, a circadian rhythm gene, was further confirmed by western blot. RESULTS: TMJ-OA model was successfully established in rats through UOT. LIPUS played a positive role in attenuating the retrogression of cartilage. The cartilage lesion was determined by HE and Safranin-O staining. A significant and bran-new gene profile of 58 mRNAs was obtained from the RNA-Seq (LIPUS-treated/placebo) and generated approximately 30GB data. Annotation, functional classification and pathway of the data were analyzed based on GO and KEGG database and ten candidate DEGs were identified. Some of these genes were proved to be related to OA, such as matrix-degrading enzyme (ADAMTS-8), complement (C1qa, C3, C5aR1). Some were reported for the first time in TMJ-OA, such as circadian gene (Per-2, Dbp, Npas2 and Arntl). According to the results of qRT-PCR validation, the sequencing data was with a high degree of credibility. The circadian gene Per-2 was up-regulated by LIPUS in TMJ-OA on the mRNA and protein level. CONCLUSION: This study reveals the potential therapeutic genes related to TMJ-OA. Especially the circadian Per-2 gene was detected up-regulated by the treatment of LIPUS. It provides us a precious, new target OA-related gene and further investigation of gene-function will provide us new insights in understanding the potential mechanical underling TMJ-OA.

Osteopontin stimulates matrix metalloproteinase expression through the nuclear factor-κB signaling pathway in rat temporomandibular joint and condylar chondrocytes.

BACKGROUND: To examine the possible regulatory mechanisms of osteopontin (OPN) and the nuclear factor-κB (NF-κB) signaling pathway in the temporomandibular joint (TMJ) of rats subjected to chronic sleep deprivation (CSD). METHODS: Rats were subjected to CSD using the modified multiple platform method. The histomorphology of the TMJ was observed by hematoxylin-eosin staining. OPN and NF-κB/p65 expression were detected by immunohistochemical and immunofluorescence staining together with western blotting. The condylar chondrocytes were isolated from the rat TMJ and treated with recombinant OPN (r-OPN) before detection for the expression of NF-κB/p65 and matrix metalloproteinases (MMPs). Western blotting and reverse transcription-polymerase chain reaction were performed to determine the expression of MMP-1, MMP-3, MMP-9, and MMP-13 in the TMJ and chondrocytes respectively. RESULTS: There was a statistically significant difference in OPN and NF-κB/p65 expression between the CSD group and control (CON) group. OPN and NF-κB/p65 expression was increased in the CSD group as compared with in the CON group. NF-κB/p65 expression was significantly increased by r-OPN treatment in the chondrocytes. Furthermore, MMP-1, MMP-3, MMP-9, and MMP-13 production was also remarkably elevated in the CSD group as well as in the chondrocytes. Treatment with 1 µg/ml r-OPN for 48 h led to the highest production of inflammatory cytokines in chondrocytes. CONCLUSIONS: CSD causes pathological alterations in the TMJ. OPN treatment activates the NF-κB signaling pathway and stimulates MMPs in the TMJ and condylar chondrocytes through NF-κB signaling pathway. Chondrocytes treated with 1 µg/ml r-OPN for 48 h produced the highest level of inflammatory cytokines.

Effects of Four Different Crown Materials on the Peri-Implant Clinical Parameters and Composition of Peri-Implant Crevicular Fluid.

This study aimed to identify the preferred crown material by measuring the peri-implant clinical parameters and the concentrations of receptor activator of nuclear factor-κB ligand (RANKL), osteoprotegerin (OPG), and calcium in peri-implant crevicular fluid (PICF) with 4 different crown materials. A total of 196 patients with a single missing posterior tooth received crown restoration with cobalt-chromium (Co-Cr) porcelain-fused-to-metal (PFM; n = 50), aurum platinum (Au-Pt) PFM (n = 48), titanium (Ti) PFM (n = 52), or zirconia (Zi) all-ceramic crown (n = 46). Fifty-one natural counterpart teeth served as controls. Before and 12 months after restoration, the PICF was collected, and the concentrations of RANKL, OPG, and calcium were quantified. The peri-implant clinical parameters (plaque index, bleeding on probing, and probing depth [PD]) and gingival crevicular fluid (GCF) volumes were assessed. Twelve months after restoration, the PD and GCF volumes for the 4 experimental groups were significantly greater than those for the control group and before restoration. The Co-Cr group showed the greatest PD, GCF volume, RANKL/OPG, RANKL, and calcium ion concentration, followed by the Au-Pt group. The Ti group had the highest OPG concentration, followed by the Zi group. The RANKL and calcium ion concentrations of the Ti and Zi groups were the smallest. The Ti group had the smallest RANKL/OPG ratio, followed by the Zi group. Different crown materials differentially affected the PD, volume, RANKL/OPG ratio, OPG, RANKL, and calcium concentration. Among the 4 tested crown materials, Zi and Ti are preferred. However, some limitations of the present study should be considered.

Hyperbaric oxygen protects type II collagen in interleukin-1ß-induced mandibular condylar chondrocyte via inhibiting the JNK/c-Jun signaling pathway.

The aim of this study was to explore the mechanisms of Hyperbaric oxygen (HBO) protective on interleukin-1ß (IL-1ß) induced rat's mandibular condylar chondrocytes. Chondrocytes were exposure to Hyperbaric oxygen after induced inflammatory by IL-1ß. After that, the expression of p-JNK and c-Jun was increased significantly, while the Sox-9 was decreased significantly, Immunofluorescence results showed that the expression of p-JNK and p-c-Jun were decreased while the expression of Sox-9 and COL2 were increased in chondrocytes treated with IL-1ß and selective JNK inhibitor. Hyperbaric oxygen might plays similar roles with the JNK-specific inhibitor SP600125, inducing the increase of Sox-9 and COL2 expression. On the whole, IL-1ß induced inflammatory in chondrocytes by activating the JNK/c-Jun signaling pathway and down-regulate the expression of Sox-9 and COL2. However, Hyperbaric oxygen can inhibits IL-1ß induced inflammatory response in chondrocytes though block the JNK/c-Jun signaling pathway and up-regulate the expression of Sox-9 and COL2.

VEGF promotes cartilage angiogenesis by phospho-ERK1/2 activation of Dll4 signaling in temporomandibular joint osteoarthritis caused by chronic sleep disturbance in Wistar rats.

Chronic sleep disturbance (CSD) has been linked to the development of temporomandibular joint osteoarthritis (TMJ-OA). While the pathogenesis of TMJ-OA is unclear, recent studies indicate that osteochondral angiogenesis is important. We developed a rat model of CSD induced TMJ-OA to investigate the changes caused by sleep disturbance and to correlate them with vascular invasion in the TMJ. We found pathological alterations and an increased microvessel density in the rat TMJ following CSD. VEGF, Dll4 and p-ERK1/2, the expression of angiogenic factors, were highly expressed in the rat mandibular condylar cartilage and their expression increased with CSD. Furthermore, we show that VEGF-induce activation of ERK1/2, which in turn, increases Dll4 expression. Together, our results suggest that CSD can cause OA-like pathological alterations in the rat TMJ by increasing angiogenesis.

Maxillary aggressive angiomyxoma showing ineffective to radiotherapy: a rare case report and review of literature.

Aggressive angiomyxoma, mostly originating in the female pelvis and peritoneum or in the male analogous sites, is a rare mesenchymal neoplasm characterized with infiltrative growth to adjacent tissue and local recurrence after primary excision. Herein, we report a case of aggressive angiomyxoma of maxilla in a 60-year-old male patient for its rarity. The patient presented with a one-year history of progressively enlarging maxillary mass on left side. Before referred to our hospital, he was given a biopsy and diagnosed as aggressive angiomyxoma by immunohistochemical staining. After that, he underwent 60 Gy radiotherapy. Unfortunately, CT scan showed bigger mass infiltrated to adjacent facial soft tissues and bones compared with that of before radiotherapy. Besides that, he began to suffer with ingravescent headache. The mass was surgically removed and the diagnosis was confirmed by immunohistology in our hospital. As a case of aggressive angiomyxoma occurred in a rare site and experienced an ongoing growth in spite of radiotherapy, its characteristics was discussed with a brief literature review, which may aid further understanding of aggressive angiomyoma.