Achieving the theoretical limit of strength in shell-based carbon nanolattices.

Recent developments in mechanical metamaterials exemplify a new paradigm shift called mechanomaterials, in which mechanical forces and designed geometries are proactively deployed to program material properties at multiple scales. Here, we designed shell-based micro-/nanolattices with I-WP (Schoen's I-graph-wrapped package) and Neovius minimal surface topologies. Following the designed topologies, polymeric microlattices were fabricated via projection microstereolithography or two-photon lithography, and pyrolytic carbon nanolattices were created through two-photon lithography and subsequent pyrolysis. The shell thickness of created lattice metamaterials varies over three orders of magnitude from a few hundred nanometers to a few hundred micrometers, covering a wider range of relative densities than most plate-based micro-/nanolattices. In situ compression tests showed that the measured modulus and strength of our shell-based micro-/nanolattices with I-WP topology are superior to those of the optimized plate-based lattices with cubic and octet plate unit cells and truss-based lattices. More strikingly, when the density is larger than 0.53 g cm-3, the strength of shell-based pyrolytic carbon nanolattices with I-WP topology was found to achieve its theoretical limit. In addition, our shell-based carbon nanolattices exhibited an ultrahigh strength of 3.52 GPa, an ultralarge fracture strain of 23%, and an ultrahigh specific strength of 4.42 GPa g-1 cm3, surpassing all previous micro-/nanolattices at comparable densities. These unprecedented properties can be attributed to the designed topologies inducing relatively uniform strain energy distributions and avoiding stress concentrations as well as the nanoscale feature size. Our study demonstrates a mechanomaterial route to design and synthesize micro-/nanoarchitected materials.

Pollen-Modified Flat Silk Cocoon Pressure Sensors for Wearable Applications.

Microstructures have been proved as crucial factors for the sensing performance of flexible pressure sensors. In this study, polypyrrole (PPy)/sunflower pollen (SFP) (P/SFP) was prepared via the in situ growth of PPy on the surface of degreased SFP with a sea urchin-like microstructure; then, these P/SFP microspheres were sprayed onto a flat silk cocoon (FSC) to prepare a sensing layer P/SFP-FSC. PPy-FSC (P-FSC) was prepared as an electrode layer through the in situ polymerization of PPy on the FSC surface. The sensing layer P/SFP-FSC was placed between two P-FSC electrode layers to assemble a P/SFP-FSC pressure sensor together with a fork finger electrode. With 6 mg/cm2 of optimized sprayed P/SFP microspheres, the prepared flexible pressure sensor has a sensitivity of up to 0.128 KPa-1 in the range of 0-13.18 KPa and up to 0.13 KPa-1 in the range of 13.18-30.65 KPa, a fast response/recovery time (90 ms/80 ms), and a minimum detection limit as low as 40 Pa. This fabricated flexible P/SFP-FSC sensor can monitor human motion and can also be used for the encrypted transmission of important information via Morse code. In conclusion, the developed flexible P/SFP-FSC pressure sensor based on microstructure modification in this study shows good application prospects in the field of human-computer interaction and wearable electronic devices.

Efficacy of epi-1 modified epirubicin and curcumin encapsulated liposomes targeting-EpCAM in the inhibition of epithelial ovarian cancer cells.

Treatment of epithelial ovarian cancer (EOC) is a challenge because it still leads to unsatisfactory clinical prognosis. This is due to the toxicity and poor targeting of chemotherapeutic agents, as well as metastasis of the tumor. In this study, we designed a targeted liposome with nanostructures to overcome these problems. In the liposomes, epirubicin and curcumin were encapsulated to achieve their synergistic antitumor efficacy, while Epi-1 was modified on the liposomal surface to target epithelial cell adhesion molecule (EpCAM). Epi-1, a macrocyclic peptide, exhibits active targeting for enhanced cellular uptake and potent cytotoxicity against tumor cells. The encapsulation of epirubicin and curcumin synergistically inhibited the formation of neovascularization and vasculogenic mimicry (VM) channels, thereby suppressing tumor metastasis on SKOV3 cells. The dual drug loaded Epi-1-liposomes also induced apoptosis and downregulated metastasis-related proteins for effective antitumor in vitro. In vivo studies showed that dual drug loaded Epi-1-liposomes prolonged circulation time in the blood and increased the selective accumulation of drug at the tumor site. H&E staining and immunohistochemistry with Ki-67 also showed that targeted liposomes elevated antitumor activity. Also, targeted liposomes downregulated angiogenesis-related proteins to inhibit angiogenesis and thus tumor metastasis. In conclusion, the production of dual drug loaded Epi-1-liposomes is an effective strategy for the treatment of EOC.

Extraction of impacted mandibular third molars in close proximity to the inferior alveolar canal with coronectomy-miniscrew traction to avoid nerve injury.

OBJECTIVES: Extraction of impacted mandibular third molars (IMTMs) is the most common surgery performed in the Department of Oral and Maxillofacial Surgery. Inferior alveolar nerve (IAN) injury is a rare but severe complication, and the risk is significantly higher in cases of IMTM near the inferior alveolar canal (IAC). The existing surgical method to extract such IMTMs is either not safe enough or is time-consuming. A better surgical design is needed. MATERIALS AND METHODS: From August 2019 to June 2022, 23 patients underwent IMTM extraction by Dr. Zhao at Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, and were found to have IMTMs in close proximity to the IAC. Due to high IAN injury risk, these patients underwent coronectomy-miniscrew traction to extract their IMTMs. RESULTS: The time between coronectomy-miniscrew insertion and complete removal of the IMTM was 32.65 ± 2.110 days, which was significantly shorter than that of traditional orthodontic traction. Two-point discrimination testing revealed no IAN injury, and no injury was reported by patients during follow-up. Other complications, such as severe swelling, severe bleeding, dry socket, and limited mouth opening, were not observed. Postoperative pain levels were not significantly higher in the coronectomy-miniscrew traction group than in the traditional IMTM extraction group. CLINICAL RELEVANCE: For IMTMs that are in close proximity to the IAC and must be extracted, coronectomy-miniscrew traction is a novel approach to minimize the risk of IAN injury in a less time-consuming way with a lower possibility of complications.

Removable partial prosthesis combined with swallowing training is an efficient clinical solution for oral cancer post-operation patients with palatal defect and dysphagia: a prospective study.

OBJECTIVE: Dysphagia is one of the major complications of oral cancer patients, and is disturbing thousands of patients worldwide. Our study aim to evaluate the clinical efficacy of prosthesis combined with swallowing training on palatal defect and dysphagia in post-operative oral cancer patients. MATERIALS AND METHODS: Sixteen oral cancer patients with palatal defect and dysphagia post-operation were treated with removable prosthesis and individualized swallowing function training. Swallowing function of patients before and after treatment was analyzed and compared by videofluoroscopic swallowing examination. The severity of depression and life quality were evaluated by Depression Scale (SDS) and Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) scores, respectively. RESULTS: Oral transit time (OTT) significantly shortened after treatment (P < 0.01), and Penetration-Aspiration Scale (PAS) scores was significantly higher after treatment (P < 0.001). Different consistency bolus showed different risk of aspiration. Thickened liquids were related to lower PAS scores (P < 0.001). SDS standard score was significantly lower after treatment (P < 0.05). The total score of FACT-H&N after treatment was significantly higher (P < 0.05). No patients came back for regressed swallowing function during the follow-up period (17.06 ± 2.376 months). CONCLUSION: Removable prosthesis and swallowing training can significantly improve swallowing function, reduce depression degree, and improve quality of life (QOL). CLINICAL RELEVANCE: Removable prosthesis combined with swallowing training is a cheap and effective method to improve QOL in patients with palate defect and dysphagia after oral cancer.

Reconstruction of Acquired Segmental Mandibular Defects Using Pedicled Mandibular Muscle Flap and Evaluation of Speech Function and Aesthetic Outcomes.

PURPOSE: The purpose of this study was to investigate the clinical effect of pedicled mandibular osteomuscular flap in the reconstouring of repair of acquired segmental mandibular defects. PATIENTS AND METHODS: Thirteen patients with acquired segmental mandibular defects requiring secondary repair were included into the study. Pedicled mandibular osteomuscular flap was applied with strong internal fixation to repair the mandibular defects. The patients' speech, swallowing function, and aesthetic changes were evaluated upon follow-up. RESULTS: The flaps were viable in all patients. Average speech function score was 7.6±0.6. All patients had a drinking test rating of grade I or II with good masticatory efficiency. The postoperative self-assessment Visual Analog Scale score of appearance was 7.8±0.8. CONCLUSIONS: Pedicled mandibular osteomuscular flap is a viable choice in the secondary repair and reconstruction of mandibular acquired segmental defects. This flap could achieve better oral function with good aesthetic results.

Method for perfusion decellularization of porcine whole liver and kidney for use as a scaffold for clinical-scale bioengineering engrafts.

BACKGROUND: Whole-organ engineering provides a new alternative source of donor organs for xenotransplantation. Utilization of decellularized whole-organ scaffolds, which can be created by detergent perfusion, is a strategy for tissue engineering. In this article, our aim is to scale up the decellularization process to human-sized liver and kidney to generate a decellularized matrix with optimal and stable characteristics on a clinically relevant scale. METHODS: Whole porcine liver and kidney were decellularized by perfusion using different detergents (1% SDS, 1% Triton X-100, 1% peracetic acid (PAA), and 1% NaDOC) via the portal vein and renal artery of the liver and kidney, respectively. After rinsing with PBS to remove the detergents, the obtained liver and kidney extracellular matrix (ECM) were processed for histology, residual cellular content analysis, and ECM components evaluation to investigate decellularization efficiency, xenoantigens removal, and ECM preservation. RESULTS: The resulting liver and kidney scaffolds in the SDS-treated group showed the most efficient clearance of cellular components and xenoantigens, including DNA and protein, and preservation of the extracellular matrix composition. In comparison, cell debris was observed in the other decellularized groups that were generated using Triton X-100, PAA, and NaDOC. Special staining and immunochemistry of the porcine liver and kidney ECMs further confirmed the disrupted three-dimension ultrastructure of the ECM in the Triton X-100 and NaDOC groups. Additionally, Triton X-100 effectively eliminated the residual SDS in the SDS-treated group, which ensured the scaffolds were not cytotoxic to cells. Thus, we have developed an optimal method that can be scaled up for use with other solid whole organs. CONCLUSIONS: Our SDS-perfusion protocol can be used for porcine liver and kidney decellularization to obtain organ scaffolds cleared of cellular material, xenoimmunogens, and preserved vital ECM components.

Functional assessment: Free thin anterolateral thigh flap versus free radial forearm reconstruction for hemiglossectomy defects.

BACKGROUND: To compare free thin anterolateral thigh (ALT) flap with free radial forearm (FRF) flap in the reconstruction of hemiglossectomy defects, and to introduce our methods and experience in the tongue reconstruction with free thin ALT flap. MATERIAL AND METHODS: The clinicopathologic data of 46 tongue carcinoma cases hospitalized from December 2009 to April 2014 were obtained from Nangjing Stomatological Hospital, Medical School of Nanjing University. All the subjects were evaluated for the articulation and the swallowing function 3 months after the surgery. RESULTS: Among these 46 patients, 12 patients underwent tongue reconstruction after hemiglossectomy with ALT flap; 34 patients underwent tongue reconstruction with FRF flap. The differences in the incidence of vascular crisis, the speech and the swallowing function between two groups were not significant (P > 0.05). CONCLUSIONS: Thin ALT flap could be one of the ideal flaps for hemiglossectomy defect reconstruction with its versatility in design, long pedicle with a suitable vessel diameter, and the neglectable donor site morbidity.

Synergistic effects of multidrug/material combination deliver system for anti-mutidrug-resistant tumor.

Multidrug resistance (MDR) is a public health issue of particular concern, for which nanotechnology-based multidrug delivery systems are considered among the most effective suppressive strategies for such resistance in tumors. However, for such strategies to be viable, the notable shortcomings of reduced loading efficiency and uncontrollable drug release ratio need to be addressed. To this end, we developed a novel "multidrug/material" co-delivery system, using d-α-tocopheryl polyethylene glycol 1000 succinate (TPGS, P-gp efflux pump inhibitor) and poly(amidoamine) (PAMAM) to fabricate a precursor material with the properties of reversing MDR and having a long-cycle. Further, to facilitate multidrug co-delivery, we loaded doxorubicin(Dox) and curcumin(Cur, cardiotoxicity modifier and P-gp inhibitor) into PAMAM-TPGS nano-micelles respectively, and mixed in appropriate proportions. The multidrug/material co-delivery system thus obtained was characterized by high drug loading and a controllable drug release ratio in the physiological environment. More importantly, in vitro and in vivo pharmacodynamic studies indicated that the multidrug/material co-delivery system facilitated the reversal of MDR. Moreover, the system has increased anti-tumor activity and is biologically safe. We accordingly propose that the "multidrug/material" co-delivery system developed in this study could serve as a potential platform for reversing MDR and achieving safe and effective clinical treatment.

Replacing cholesterol with asiatic acid to prolong circulation and enhance anti-metastatic effects of non-PEGylated liposomes.

Cholesterol is an indispensable component of most liposomes, heavily influencing their physical and surface properties. In this study, cholesterol in non-PEGylated liposomes was replaced by its analog, asiatic acid (AA), to generate liposomes with an alternative composition. These AA liposomes are generally smaller and more rigid than conventional liposomes, circulate longer in the body, and accumulate more in primary tumors and lung metastases in vivo. On the other hand, as an active ingredient, AA can decrease TGF-ß secretion to inhibit the epithelial-mesenchymal transition (EMT) process, increase the sensitivity of tumor cells to doxorubicin (DOX), and synergize with DOX to enhance the immune response, thus improving their antitumor and anti-metastasis efficiency. Based on this rationale, DOX-loaded AA liposomes were fabricated and tested against triple-negative breast cancer (TNBC). Results showed that compared with conventional liposomes, the DOX-AALip provided approximately 28.4% higher tumor volume reduction with almost no metastatic nodules in the mouse model. Our data demonstrate that AA liposomes are safe, simple, and efficient, and thus in many situations may be used instead of conventional liposomes, having good potential for further clinical translational development.

Construction of ROS-Responsive Hyaluronic Acid Modified Paclitaxel and Diosgenin Liposomes and Study on Synergistic Enhancement of Anti-Ovarian Cancer Efficacy.

Purpose: Ovarian cancer is a fatal gynecologic malignancy with a high rate of abdominal metastasis. Chemotherapy still has a poor clinical prognosis for ovarian cancer patients, with cell proliferation and angiogenesis leading to invasion, migration, and recurrence. To overcome these obstacles, we constructed a novel HA-modified paclitaxel and diosgenin liposome (PEG-TK-HA-PDLPs) using two novel functional materials, DSPE-PEG2000-HA and DSPE-PEG2000-TK-PEG5000, to specifically deliver the drugs to the tumor site in order to reduce OC cell proliferation and anti-angiogenic generation, thereby inhibiting invasion and migration. Methods and Results: PEG-TK-HA-PDLPs were prepared by film dispersion, with ideal physicochemical properties and exhibits active targeting for enhanced cellular uptake. The ZIP synergy score for PTX and Dios was calculated using the online SynergyFinder software to be 3.15, indicating synergy. In vitro results showed that PEG-TK-HA-PDLPs were highly cytotoxic to ID8 cells, induced ID8 cell apoptosis, and inhibited ID8 cell migration and invasion. In vivo studies showed that PEG-TK-HA-PDLPs could prolong the circulation time in the blood, accumulate significantly in the tumor site, and effectively fight against angiogenesis with significant anti-tumor effects. Conclusion: The production of PEG-TK-HA-PDLPs is an effective strategy for the treatment of OC.

Skin-friendly corrugated multilayer microspherical sensor fabricated with silk fibroin, poly (lactic-co-glycolic acid), polyaniline, and kappa-carrageenan for wide range pressure detection.

To enlarge the linear detection range without sacrificing the sensitivity is one of the urgent problems in the development of high-performance piezoresistive flexible sensors. Inspired by a multilayer corrugated board, this study develops a new multilayer microspherical sensor in which conductive core-shell SiO2/Polyaniline (PANI) (PS) microspheres serve as active particles, while insulated silk fibroin (SF)/poly lactic-co-glycolic acid (PLGA) (SP) fibers are used as the support. The size of conductive microspheres attached to the insulated layer is controllable. The multiple layers of assembly endow the flexible sensor with a high sensitivity (0.071 kPa-1) and a wide linear detection (from 10 Pa to 380 kPa) simultaneously. This corrugated sensor also have a fast response time (145 ms) and an excellent durability (over 2000 cycles), and it can be used to detect human joint pressure signals and transmit encrypted information. Moreover, flexible keyboard, safety protection of machinery, as well as object position tracking can be achieved based on this sensor. Most importantly, the sensor encapsulated by biological polysaccharide kappa-carrageenan (KC) is skin-friendly and breathable, and it can be decomposed in 90 °C hot water. In conclusion, this multilayer microspherical sensor presents great potential for flexible wearable devices.

Folate-modified triptolide liposomes target activated macrophages for safe rheumatoid arthritis therapy.

Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial joint hyperplasia, joint inflammation, cartilage erosion and bone destruction. Macrophages play an essential role in the pathogenesis of RA, and folate receptor ß (FR-ß) is highly expressed on the surface of activated synovial macrophages in RA patients. Triptolide (TP) has anti-inflammatory properties, and it can protect the cartilage matrix, but its clinical application has been limited due to poor solubility, low bioavailability and systemic toxicity. Therefore, we constructed folate-modified triptolide liposomes (FA-TP-Lips) to target macrophages, thereby treating RA in a safe and effective way. The experiments indicated that FA-TP-Lips had properties of small particle size, uniform particle size distribution, high drug encapsulation and long circulation. Furthermore, FA-TP-Lips showed reduced cytotoxicity, increased cellular uptake and significant anti-inflammatory effects in vitro. It also inhibited osteoclastogenesis. In vivo experiments revealed that liposomes could prolong the circulation of TP in the body, as well as exhibit significant cartilage-protective and anti-inflammatory effects with lower toxicity compared with the free TP group, thereby providing a promising new approach for the treatment of RA.

[Bibliometric analysis on key elements of clinical application of acupoint catgut embedding therapy in recent ten years].

OBJECTIVE: To analyze the characteristics of acupoint catgut embedding methods, tools, catgut types, and the treatment cycles in the clinical research in recent ten years both at home and abroad, so as to summarize its regularities and to provide technical references for further studies. METHODS: Articles about clinical researches on catgut embedding therapy published in recent ten years (from January 1, 2010 to December 31,2020) were retrieved from the databases of CNKI, Wanfang, VIP, and PubMed by using key words of "acupoint embedding" "acupoint catgut embedding" and "catgut implantation at acupoint". According to the inclusion and exclusion criteria, a new database was established for analyzing the data mentioned above. RESULTS: 1) A total of 1 196 articles were collected, including 15 English articles and 1 181 Chinese articles, presenting a fluctuating increasing trend in recent ten years. 2) The commonly used acupoint embedding methods included disposable catgut embedment needle method (399 times, 38.89%) and disposable syringe needle catgut embedding method (347 times, 33.82%), for which two or multiple methods were mentioned in the same one article. 3) The most frequently used top two tools for catgut embedding were the dispo-sable catgut embedment needle (463 times, 43.03%) and disposable syringe needle (406 times,37.73%), with a significant increase in the application of disposable syringe needle. The most commonly used size of tools included No. 7 (283 times, 39.86%), No. 9 (196 times, 27.61%) and No. 8 (109 times, 15.35%). 4) The most frequently implanted surgical suture was still the common catgut (671 times, 58.15%) despite of a reduction in clinical application year by year, and the types of the implanted suture materials were gradually enriched since 2018, such as the absorbable surgical suture, polyethylprolactide(PGLA), collagen protein thread, polydioxanone(PPDO), etc. The commonly used implanted catgut size was 3-0 (227 times, 30.15%), 2-0 (176 times, 23.37%), 4-0 (131 times, 17.40%), 0 (103 times, 13.68%), with the commonly used catgut length being 1 cm (332 times, 35.55%), 1.5 cm (103 times, 11.03%), 1-2 cm (92 times, 9.85%) and 2 cm (92 times, 9.85%). 5) The intervals of the catgut implantation were 7 days (313 times, 28.95%), 14 days (262 times, 24.24%), 10 days (174 times, 16.10%), and 15 days (162 times, 14.99%). CONCLUSION: In recent ten years, clinical research on acupoint catgut embedding is growing rapidly, and the embedding methods, tools, implanted sutures, and embedding intervals are various, which may provide certain technical references for the future researches and suggest an urgent need of formulation of the standardized and unified standards in this field.

Similarity and Potential Relation Between Periimplantitis and Rheumatoid Arthritis on Transcriptomic Level: Results of a Bioinformatics Study.

Background: This bioinformatics study aimed to reveal potential cross-talk genes, related pathways, and transcription factors between periimplantitis and rheumatoid arthritis (RA). Methods: The datasets GSE33774 (seven periimplantitis and eight control samples) and GSE106090 (six periimplantitis and six control samples) were included from the National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (GEO). A differential expression analysis (p < 0.05 and |logFC (fold change)| ≥ 1) and a functional enrichment analysis (p < 0.05) were performed. Based on this, a protein-protein interaction (PPI) network was constructed by Cytoscape. RA-related genes were extracted from DisGeNET database, and an overlap between periimplantitis-related genes and these RA-related genes was examined to identify potential cross-talk genes. Gene expression was merged between two datasets, and feature selection was performed by Recursive Feature Elimination (RFE) algorithm. For the feature selection cross-talk genes, support vector machine (SVM) models were constructed. The expression of these feature genes was determined from GSE93272 for RA. Finally, a network including cross-talk genes, related pathways, and transcription factors was constructed. Results: Periimplantitis datasets included 138 common differentially expressed genes (DEGs) including 101 up- and 37 downregulated DEGs. The PPI interwork of periimplantitis comprised 1,818 nodes and 2,517 edges. The RFE method selected six features, i.e., MERTK, CD14, MAPT, CCR1, C3AR1, and FCGR2B, which had the highest prediction. Out of these feature genes, CD14 and FCGR2B were most highly expressed in periimplantitis and RA. The final activated pathway-gene network contained 181 nodes and 360 edges. Nuclear factor (NF) kappa B signaling pathway and osteoclast differentiation were identified as potentially relevant pathways. Conclusions: This current study revealed FCGR2B and CD14 as the most relevant potential cross-talk genes between RA and periimplantitis, which suggests a similarity between RA and periimplantitis and can serve as a theoretical basis for future research.

Nanoscale 3D Bioprinting for Osseous Tissue Manufacturing.

3D printing, as a driving force of innovation over many areas, brings numerous manufacturing methods together from the macro to nano scales. New revolutionary materials (such as polymeric materials and natural biomaterials) can be produced into unique 3D printed nanostructures. The morphology and functionality of various 3D printing methods as well in vitro and in vivo results of their use towards regenerating bone are discussed in this review. This review further focuses nano scale 3D bioprinting technology for bone tissue engineering, mainly including recent progress in research on technical materials and methods, typical applications, and crucial achievements; explaining the scientific and technical challenges for bone tissue fabrication; and describing micro-nano scale 3D printing application prospects, development directions, and trends for the future for this field to realize its full potential.

Genipin crosslinking reduced the immunogenicity of xenogeneic decellularized porcine whole-liver matrices through regulation of immune cell proliferation and polarization.

Decellularized xenogeneic whole-liver matrices are plausible biomedical materials for the bioengineering of liver transplantation. A common method to reduce the inflammatory potential of xenogeneic matrices is crosslinking. Nevertheless, a comprehensive analysis of the immunogenic features of cross-linked decellularized tissue is still lacking. We aimed to reduce the immunogenicity of decellularized porcine whole-liver matrix through crosslinking with glutaraldehyde or genipin, a new natural agent, and investigated the mechanism of the immune-mediated responses. The histologic assessment of the host's immune reaction activated in response to these scaffolds, as well as the M1/M2 phenotypic polarization profile of macrophages, was studied in vivo. The genipin-fixed scaffold elicited a predominantly M2 phenotype response, while the glutaraldehyde-fixed scaffold resulted in disrupted host tissue remodeling and a mixed macrophage polarization profile. The specific subsets of immune cells involved in the responses to the scaffolds were identified in vitro. Crosslinking alleviated the host response by reducing the proliferation of lymphocytes and their subsets, accompanied by a decreased release of both Th1 and Th2 cytokines. Therefore, we conclude that the natural genipin crosslinking could lower the immunogenic potential of xenogeneic decellularized whole-liver scaffolds.

[Surgical management of temporomandibular joint ankylosis under the guidance of navigation].

OBJECTIVE: To assess the safety and the accuracy of surgical navigation technology in the resection of severe ankylosis of the mandibular condyle with the middle cranial fossa. METHODS: The CT scan data was transferred to a Windows-based computer workstation, and the patient' s individual anatomy was assessed in multiplanar views at the workstation. In the operation, the patient and the virtual image were matched by individual registration with the reference points which were set on the skull bone surface and the teeth. Then the real time navigation can be performed. RESULTS: The acquisition of the data sets was uncomplicated, and image quality was sufficient to assess the operative result in three cases. The operations were performed successfully with the guidance of real-time navigation. The application of surgical navigation have enhanced the safety and the accuracy of the surgery for bony ankylosis of temporomandibular joint. CONCLUSIONS: The application of surgical navigation can improve the accuracy and safety of surgical excision of the ankylosed skull base tissue.