Open Reduction Effects of Digitally Treating Zygomaticomaxillary Complex Fractures With Bio-Resorbable Materials.

PURPOSE: The application of bio-resorbable plates in craniomaxillofacial surgery is increasing because of the advantage of avoiding secondary surgery. This study aimed to evaluate the effects of osteosynthesis with prebent bio-resorbable plates for treating zygomaticomaxillary complex (ZMC) fractures. MATERIALS AND METHODS: We implemented a prospective case series composed of patients with ZMC fractures who underwent treatment at the School of Stomatology at China Medical University. Bio-resorbable plates were used for fracture fixation. The fractures were stabilized with bio-resorbable plates prebent on a 3-dimensionally printed skull model with the fractures reduced using virtual simulation. The primary outcome variable was the stability rate of reduced bone segments. Other study variables were mouth opening, occlusion, paresthesia or anesthesia in the infraorbital nerve region (PAIN), and diplopia. Outcome variables were determined by calculating stability rates of reduced bone segments, resolution rates of postoperative restricted mouth opening, malocclusion, PAIN, and diplopia. RESULTS: The sample was composed of 11 patients recruited between November 2016 and September 2018. All surgical procedures were successful, with no severe complications. The stability rate of reduced bone segments from different mechanical buttress regions was 100%. Satisfactory postoperative stability of bio-resorbable plates was obtained in all cases. The resolution rates of postoperative restricted mouth opening and malocclusion were 75 and 100%, respectively. PAIN and diplopia symptoms resolved in 50 and 100% of cases, respectively. CONCLUSIONS: The results suggest that osteosynthesis with bio-resorbable plates prebent on a 3-dimensionally printed skull model, designed by virtual simulation, works well for patients with ZMC fractures. Future studies should focus on the broader applications of these findings in the practice of oral and maxillofacial surgery.

Acceleration of Bone Regeneration in Critical-Size Defect Using BMP-9-Loaded nHA/ColI/MWCNTs Scaffolds Seeded with Bone Marrow Mesenchymal Stem Cells.

Biocompatible scaffolding materials play an important role in bone tissue engineering. This study sought to develop and characterize a nano-hydroxyapatite (nHA)/collagen I (ColI)/multi-walled carbon nanotube (MWCNT) composite scaffold loaded with recombinant bone morphogenetic protein-9 (BMP-9) for bone tissue engineering by in vitro and in vivo experiments. The composite nHA/ColI/MWCNT scaffolds were fabricated at various concentrations of MWCNTs (0.5, 1, and 1.5% wt) by blending and freeze drying. The porosity, swelling rate, water absorption rate, mechanical properties, and biocompatibility of scaffolds were measured. After loading with BMP-9, bone marrow mesenchymal stem cells (BMMSCs) were seeded to evaluate their characteristics in vitro and in a critical sized defect in Sprague-Dawley rats in vivo. It was shown that the 1% MWCNT group was the most suitable for bone tissue engineering. Our results demonstrated that scaffolds loaded with BMP-9 promoted differentiation of BMMSCs into osteoblasts in vitro and induced more bone formation in vivo. To conclude, nHA/ColI/MWCNT scaffolds loaded with BMP-9 possess high biocompatibility and osteogenesis and are a good candidate for use in bone tissue engineering.

Minimally-invasive open reduction of intracapsular condylar fractures with preoperative simulation using computer-aided design.

Reduction of intracapsular condylar fractures is difficult, so we have based our technique on preoperative simulation using computer-aided design (CAD), which has proved useful in other surgical specialties. We have treated 11 patients with intracapsular condylar fractures. Before the operation the procedure was shown on the computer using a three-dimensional simulation system. The relation between the stump and the fragment of the condyle, and assessment of the position and the size of the screw, were made preoperatively to obtain a perfect fit. The displaced fragment was reduced by elevators, and fixed with a bicortical screw through a minimised preauricular incision under general anaesthesia. The fragments and the location of the screws were similar on the preoperative simulation and on the postoperative computed tomographic (CT) scan. The reduction and fixation of the fracture showed a perfect fit on the same view in the preoperative CAD simulation in the Mimics 10.01 software and postoperatively. Postoperative clinical examinations showed good occlusion and satisfactory mouth opening. Two patients had temporary paralysis of the occipitofrontalis muscle that recovered within 3 months. All patients regained normal mandibular movements and had short and invisible scars at 6 months' follow up. The technique of CAD simulation could help to improve the accuracy during open treatment for intracapsular condylar fractures.

[Intralesional pingyangmycin injection in the management of macrocystic lymphatic malformations in cervical region].

PURPOSE: To investigate the therapeutic effects of pingyangmycin injection as a primary therapy of macrocystic lymphatic malformations in cervical region. METHODS: Thirty-six patients with macrocystic lymphatic malformations in cervical region underwent the therapy of pingyangmycin injection between 2009 and 2012 at School of Stomatology, China Medical University. Among them, 16 patients had unilateral submandibular lesions, 20 patients had lesions in anterior cervical regions. The age of patients was from 6 months to 25 years old. The concentration of the drug was 1.6 mg /mL with an addition of lidocaine. The dose and cycle of treatment were dependent on the lesions' size and patients' age. The follow-up period was 12 months to 2 years after the last treatment. RESULTS: The total effective rate was 100%, and the curative rate was 94.4%. No serious complications were encountered. CONCLUSIONS: Intralesional Injection of pingyangmycin provides a safe and effective treatment for macrocystic lymphatic malformations in cervical region as a primary treatment.

Differentiation of columnar epithelia: the hensin pathway.

Epithelia, the most common variety of cells in complex organisms exist in many shapes. They are sheets of polarized cells that separate two compartments and selectively transport materials from one to the other. After acquiring these general characteristics, they differentiate to become specialized types such as squamous columnar or transitional epithelia. High density seeding converts a kidney-derived cell line from flat ;generic' epithelial cells to columnar cells. The cells acquire all the characteristics of differentiated columnar cells, including microvilli, and the capacity for apical endocytosis. The high seeding density induces the deposition of a new protein termed hensin and polymerization of hensin is the crucial event that dictates changes in epithelial phenotype. Hensin is widely expressed in most epithelia. Its deletion in mice leads to embryonic lethality at the time of generation of the first columnar epithelium, the visceral endoderm. Moreover many human cancers have deletions in the hensin gene, which indicates that it is a tumor suppressor.