A retrospective study of occlusal reconstruction in patients with old jaw fractures and dentition defects.

PURPOSE: This study evaluated the methods and clinical effects of multidisciplinary collaborative treatment for occlusal reconstruction in patients with old jaw fractures and dentition defects. METHODS: Patients with old jaw fractures and dentition defects who underwent occlusal reconstruction at the Third Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2022 were enrolled. Clinical treatment was classified into 3 phases. In phase I, techniques such as orthognathic surgery, microsurgery, and distraction osteogenesis were employed to reconstruct the correct three-dimensional (3D) jaw position relationship. In phase II, bone augmentation and soft tissue management techniques were utilized to address insufficient alveolar bone mass and poor gingival soft tissue conditions. In phase III, implant-supported overdentures or fixed dentures were used for occlusal reconstruction. A summary of treatment methods, clinical efficacy evaluation, comparative analysis of imageological examinations, and satisfaction questionnaire survey were utilized to evaluate the therapeutic efficacy in patients with traumatic old jaw fractures and dentition defects. All data are summarized using the arithmetic mean and standard deviation and compared using independent sample t-tests. RESULTS: In 15 patients with old jaw fractures and dentition defects (an average age of 32 years, ranging from 18 to 53 years), there were 7 cases of malocclusion of single maxillary fracture, 6 of malocclusion of single mandible fracture, and 2 of malocclusion of both maxillary and mandible fractures. There were 5 patients with single maxillary dentition defects, 2 with single mandibular dentition defects, and 8 with both maxillary and mandibular dentition defects. To reconstruct the correct 3D jaw positional relationship, 5 patients underwent Le Fort I osteotomy of the maxilla, 3 underwent bilateral sagittal split ramus osteotomy of the mandible, 4 underwent open reduction and internal fixation for old jaw fractures, 3 underwent temporomandibular joint surgery, and 4 underwent distraction osteogenesis. All patients underwent jawbone augmentation, of whom 4 patients underwent a free composite vascularized bone flap (26.66%) and the remaining patients underwent local alveolar bone augmentation. Free gingival graft and connective tissue graft were the main methods for soft tissue augmentation (73.33%). The 15 patients received 81 implants, of whom 11 patients received implant-supported fixed dentures and 4 received implant-supported removable dentures. The survival rate of all implants was 93.82%. The final imageological examination of 15 patients confirmed that the malocclusion was corrected, and the clinical treatment ultimately achieved occlusal function reconstruction. The patient satisfaction questionnaire survey showed that they were satisfied with the efficacy, phonetics, aesthetics, and comfort after treatment. CONCLUSION: Occlusal reconstruction of old jaw fractures and dentition defects requires a phased sequential comprehensive treatment, consisting of 3D spatial jaw correction, alveolar bone augmentation and soft tissue augmentation, and implant-supported occlusal reconstruction, achieving satisfactory clinical therapeutic efficacy.

Three-dimensional evaluation of dental characteristics in patients with Cleidocranial dysplasia.

BACKGROUND: Cleidocranial dysplasia (CCD) is an autosomal dominant hereditary disorder. Besides skeletal abnormalities, CCD is often associated with dental complications, such as multiple supernumerary teeth and permanent teeth impaction or delayed eruption. METHODS: Supernumerary teeth of axial, sagittal and coronal CBCT view was characterized in detail and 3D image reconstruction was performed. Number and location of teeth, morphology of supernumerary teeth, positional relationship between supernumerary and adjacent permanent teeth, direction of supernumerary teeth in CCD patients were analyzed. RESULTS: The mean age of the 3 CCD patients in this study was 16.7 years. Among 36 supernumerary teeth, the majority of them were identified as apical side located and lingual side located. Normal orientation was the most common type in this study, followed by sagittal orientation, and horizontal orientation. Horizontal orientation teeth were all distributed in the mandible. Supernumerary teeth exhibited significantly shorter crown and dental-root lengths, as well as smaller crown mesiodistal and buccolingual diameters (P < 0.01). There was no difference in the number of supernumerary teeth between the maxilla and mandible, and the premolars region had the largest number of supernumerary teeth and the incisor region had the smallest number. CONCLUSIONS: This study compares number and location of teeth, morphology of supernumerary teeth, positional relationship between supernumerary and adjacent permanent teeth and direction of supernumerary teeth, this study also provides a reference for the comprehensive evaluation of CCD patients before surgery.

Effects of cascade dams on the occurrence and distribution of microplastics in surface sediments of Wujiang river basin, Southwestern China.

The influence of cascade dams on the migration of microplastics (MPs) was conducted by analyzing the spatial distribution of MPs in sediments of the Wujiang river basin (Wujiang river basin) in Southwest China. The results showed that the abundance of MPs in Wujiang river basin sediments ranged from 310 to 2620 items/kg dw (mean: 1354 items/kg dw, a high level compared with aquatic sediments worldwide). The main chemical components of these MPs were polypropylene and polyethylene. High abundance of MPs in tributary sediments suggested that tributary inputs contributed to the main stream and reservoirs. Statistical analysis showed that gross domestic product (GDP) and the basin area of cascade reservoirs, rather than hydraulic retention time and reservoir age, were the dominating factors in the distribution of MPs in the Wujiang river basin. The accumulation of MPs in cascade reservoirs implied the interception effect of cascade dams. The rapid development of cascade dam systems and the interception effect of dams should be taken into account when predicting the flux of MPs from rivers to the ocean. Heavy metals found on the surface of the MPs showed the compound pollution of MPs and heavy metals in dammed rivers and cascade reservoirs. Our results deepen the understanding of the migration of MPs in rivers alongside intensive cascade hydropower development.

Review on Health Impacts from Domestic Coal Burning: Emphasis on Endemic Fluorosis in Guizhou Province, Southwest China.

Endemic fluorosis in Guizhou Province, Southwest China was firstly reported by Lyth in 1946 and was extensively concerned since the early 1980s. Initially, the pathological cause of endemic fluorosis in Guizhou Province was instinctively ascribed to the drinking water. However, increasing evidences pointed that the major exposure route of fluorine for the local residents is via the roasted foodstuffs, especially the roasted pepper and corn. Source of fluorine in roasted foodstuffs was once blamed on the local coal and subsequently imputed to clay mixed in the coal. In fact, both are probably the source. Geogenic fluorine concentration in soil and clay is indeed high in Guizhou Province, but is not likely to be the direct cause for endemic fluorosis. The real culprit for endemic fluorosis in Guizhou Province is the unhealthy lifestyle of the local residents, who usually roasted their foodstuffs using local coal or briquettes (a mixture of coal and clay), resulting in the elevated fluorine in roasted foodstuffs. Nowadays, endemic fluorosis in Guizhou Province has substantially mitigated. Nevertheless, millions of confirmed cases of dental fluorosis remain left. In addition to endemic fluorosis, other health problems associated with domestic coal burning may also exist, because of the enrichment of toxic/harmful elements in the local coal. It is necessary to determine how serious the situation is and find out the possible solution. As people in other developing countries may suffer from similar health issues, same health issues around the world deserve more attention.

How Does the Remodeling Capacity of Children Affect the Morphologic Changes of Fractured Mandibular Condylar Processes After Conservative Treatment?

PURPOSE: Our aim was to explore how the remodeling capacity of children's mandibular condyles affected the morphologic changes of fractured condyles after conservative treatment. PATIENTS AND METHODS: A retrospective study was designed and performed in children and adult patients with mandibular condylar fractures. Computed tomographic imaging was reviewed for all patients to analyze the morphologic changes and risk factors for traumatic temporomandibular joint ankylosis. RESULTS: From 2012 to 2017, 81 patients younger than 18 years and 10 adult patients accepted treatment in our department. There were 23 young patients (aged <18 years) with 41 fractured condyles and 10 adults with 14 fractured condyles who were managed with conservative treatment, and the morphologic changes were analyzed with the aid of Mimics 19.0 software (Materialise, Leuven, Belgium). The fractured condyles with intracapsular fractures completed the remodeling progress within 3 to 4 months, and condyles with neck or base fractures took more than 6 months. In contrast, we found no remodeling in adults. Of the 81 young patients, 3 had temporomandibular joint ankylosis. Each case was analyzed regarding the risk factors, morphologic changes, and remodeling features. Finally, the common points of these cases were summarized. CONCLUSIONS: The shape of fractured condyles can be remodeled after conservative treatment in young patients instead of bony fusion between the fractured fragments compared with adult patients.

Extensive abundances and characteristics of microplastic pollution in the karst hyporheic zones of urban rivers.

Cities are potential areas for microplastic pollution due to large-scale production and the use of plastic products. The karst ecosystem in southwestern China is fragile, and pollutants are more likely to be transported over long distance, resulting in higher pollution risks. Understanding the abundance and composition of microplastics in karst urban water systems is crucial for microplastic pollution management in a karst region. This study investigates the abundances and characteristics of microplastics typically found in river sediments in 10 cities in karst regions of Southwest China. The results show that the abundance of microplastics in sediments ranged from 800 items·kg-1 to 4400 items·kg-1, with an average of 2273 ± 775 items·kg-1 (n = 30), indicating high abundance. Polyamide (PA) was the most common plastic polymer types in all sediment samples. The abundance of microplastics in the downstream (2527 ± 698 items·kg-1) was higher than that in the midstream (2350 ± 999 items·kg-1) and upstream areas (1943 ± 370 items·kg-1), indicating a gradual accumulation effect in the karst water systems. Microplastic abundance in cities (2119 ± 838 items·kg-1) was lower than in counties (2427 ± 671 items·kg-1). No significant correlation was found between microplastic abundance in rivers of urban areas and the level of regional population and economy, but significantly negatively correlated with the efficiency of urban sewage treatment. The results obtained from this study provided insights into the management of microplastic pollution in urban river of a karst region.

Effect of cascade damming on microplastics transport in rivers: A large-scale investigation in Wujiang River, Southwest China.

Rivers are the important channels for transporting microplastics into the ocean from land. Prosperous dam construction changed the connectivity of rivers, thereby reducing the flux of microplastics to the ocean. However, this process currently lacks verification for the large-scale watersheds. In this study, we investigated the Wujiang River in China to evaluate the interception of cascade dams on microplastics. The results showed that: 1) The midstream exhibits a high abundance of microplastics (606.6-1046.2 items·kg-1) while the upstream and downstream reach exhibits relatively low pollution levels. The small-sized microplastics of 0-0.5 mm are easily migrated into downstream while the large-sized microplastics of 0.5-5 mm tend to deposit. 2) Ten kinds of plastic materials were found, in which polyethylene and polypropylene, originated from the developed tourism and fishery, account for 74.2% in all samples. 3) The earliest microplastics were found in the sediments of 1962. The abundance of microplastics in the sediments in seven reservoirs increased over time, impling the contribution of increasing human activities. 4) Positive correlations between the abundance of microplastics in sediments and local gross domestic product (GDP) (n = 33, R2 = 0.89, p < 0.05) and negative correlations between microplastics abundance and reservoir basin area (n = 33, R2 = 0.42, p < 0.05) revealed that GDP and watershed area are the key factors that control the distribution of microplastics. Our results help to understand the migration of microplastics between terrestrial and marine ecosystems.