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.

Evaluation of joint kinematics in patients with condylar reconstruction using mandibular motion simulation based on intraoral scanning registration.

AIM: To summarize the features of condylar kinematics in patients with condylar reconstruction using a mandibular motion simulation method based on intraoral scanning registration. MATERIALS AND METHODS: Patients undergoing unilateral segmental mandibulectomy and autogenous bone reconstruction as well as healthy volunteers were enrolled in the study. Patients were grouped based on whether the condyles were reconstructed. Mandibular movements were recorded using a jaw tracking system, and kinematic models were simulated after registration. The path inclination of the condyle point, margin of border movement, deviation, and chewing cycle were analyzed. A t test and one-way analysis of variance (ANOVA) were carried out. RESULTS: A total of 20 patients, including 6 with condylar reconstruction and 14 with condylar preservation as well as 10 healthy volunteers were included. The patients with condylar reconstruction showed flatter movement paths of the condyle points. The mean inclination angle of the condylar movement paths of the patients with condylar reconstruction (0.57 ± 12.54 degrees) was significantly smaller than that of those with condylar preservation (24.70 ± 3.90 degrees, P = 0.014) during both maximum opening and protrusion (7.04 ± 12.21 degrees and 31.12 ± 6.79 degrees, respectively, P = 0.022). The inclination angle of the condylar movement paths of the healthy volunteers was 16.81 ± 3.97 degrees during maximum opening and 21.54 ± 2.80 degrees during protrusion; no significant difference compared with the patients. The condyles of the affected side tended to deviate laterally in all patients during mouth opening and protrusion. Patients with condylar reconstruction showed more severe symptoms of mouth opening limitation and mandibular movement deviation as well as shorter chewing cycles than patients with condylar preservation. CONCLUSION: Patients with condylar reconstruction showed flatter movement paths of the condyle points, greater lateral motion range, and shorter chewing cycles than those with condylar preservation. The method of mandibular motion simulation based on intraoral scanning registration was feasible to simulate condylar movement.

Designing customized temporomandibular fossa prosthesis based on envelope surface of condyle movement: validation via in silico musculoskeletal simulation.

Objective: This study presents an innovative articular fossa prosthesis generated by the envelope surface of condyle movement, and compares its mandible movements, muscle activities, and joint reaction forces with two temporomandibular joint (TMJ) prostheses using multibody musculoskeletal simulation. Methods: A healthy 23-year-old female was recruited for this study. Cone-beam computed tomographic (CBCT) was performed to reconstruct the mandibular bone geometry. A customized TMJ fossa prosthesis was designed based on the subject-specific envelope surface of condyle movement (ESCM). Mandibular kinematics and jaw-closing muscle electromyography (EMG) were simultaneously recorded during maximum jaw opening-closing movements. To validate our prosthesis design, a mandibular musculoskeletal model was established using flexible multibody dynamics and the obtained kinematics and EMG data. The Biomet fossa prosthesis and the ellipsoidal fossa prosthesis designed by imitating the lower limb prostheses were used for comparison. Simulations were performed to analyze the effects of different fossa prostheses on jaw opening-closing motions, mandibular muscle activation, and contact forces. Results: The maximum opening displacement for the envelope-based fossa prosthesis was greater than those for Biomet and ellipsoidal prostheses (36 mm, 35 mm, and 33 mm, respectively). The mandibular musculoskeletal model with ellipsoidal prosthesis led to dislocation near maximal jaw opening. Compared to Biomet, the envelope-based fossa reduced the digastric and lateral pterygoid activation at maximal jaw opening. It also reduced the maximal resistance to condylar sliding on the intact side by 63.2 N. Conclusion: A customized TMJ fossa prosthesis was successfully developed using the ESCM concept. Our study of musculoskeletal multibody modeling has highlighted its advantages and potential. The artificial fossa design successfully achieved a wider condylar range of motion. It also reduced the activation of jaw opening muscles on the affected side and resistance on the intact side. This study showed that an ESCM-based approach may be useful for optimizing TMJ fossa prostheses design.

Multistable dynamics and attractors self-reproducing in a new hyperchaotic complex Lü system.

Multistable dynamics analysis of complex chaotic systems is an important problem in the field of chaotic communication security. In this paper, a new hyperchaotic complex Lü system is proposed and its basic dynamics are analyzed. Owing to the introduction of complex variables, the new system has some structurally distinctive attractors, such as flower-shaped and airfoil-shaped attractors. In addition, the evolution process of the limit cycle is also investigated. Next, the multistable coexistence behavior of the system is researched by the method of attraction basins, and the coexistence behavior of two types of hyperchaotic attractors and one type of chaotic and periodic attractors of the system are analyzed. The coexisting hyperchaotic attractors also show flower and airfoil shapes, and four types of coexistence flower-shaped attractors with different structures are perfectly explored. Moreover, the variation of coexistence attractors in the plane and space with parameters is discussed. Then, by introducing a specific piecewise function determined by a two-element method into the new high-dimensional system, the self-reproduction of the attractor can be realized to generate the multistability, and the general steps of attractors self-reproducing in the higher dimensional system are given. Finally, the circuit design of the new system is implemented, which lays a foundation for the application of complex chaotic systems.

Prediction of condylar movement envelope surface based on facial morphology.

The present study aimed to predict the envelope surfaces from facial morphology. Condylar envelope surfaces for 34 healthy adults were formed and simplified as sagittal section curves. Cephalometric and maximum mandibular moving distances measurement were performed on the participants. There was no statistically significant difference (p = 0.763) between the left and right maximum lateral movements. There was a statistically significant difference in the mandibular body length between the sexes. The envelope surfaces were divided into type 1 with Hp2 ≥ 1/3 Hp1 and type 2 with Hp2 < 1/3 × Hp1. SNA and SNB for type 2 were significantly greater than those for type 1 (p < 0.001). Therefore, the participants were divided into four groups based on gender and envelope surface morphology. The curves could be fitted using the second-order Fourier function (R-square ≥0.95). Six facial parameters were selected and a matrix was used to map facial morphology to the envelope surface. Individual sagittal curves were predicted using the matrix and facial parameters, and the envelope surface was predicted using the curve and the condyle model. Deviation analysis for the predicted envelope surface using the actual envelope as a reference was carried out (root mean square = 0.9970 mm ± 0.2918 mm). This method may lay a foundation for the geometric design of artificial fossa components of temporomandibular joint replacement systems. It may improve prosthesis design without flexible tissue repair and guide the movement of the artificial joint head.

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.

Functionalized Microscaffold-Hydrogel Composites Accelerating Osteochondral Repair through Endochondral Ossification.

Osteochondral regeneration remains a key challenge because of the limited self-healing ability of the bone and its complex structure and composition. Biomaterials based on endochondral ossification (ECO) are considered an attractive candidate to promote bone repair because they can effectively address the difficulties in establishing vascularization and poor bone regeneration via intramembranous ossification (IMO). However, its clinical application is limited by the complex cellular behavior of ECO and the long time required for induction of the cell cycle. Herein, functionalized microscaffold-hydrogel composites are developed to accelerate the developmental bone growth process via recapitulating ECO. The design comprises arginine-glycine-aspartic acid (RGD)-peptide-modified microscaffolds loaded with kartogenin (KGN) and wrapped with a layer of RGD- and QK-peptide-comodified alginate hydrogel. These microscaffolds enhance the proliferation and aggregation behavior of the human bone marrow mesenchymal stem cells (hBMSCs); the controlled release of kartogenin induces the differentiation of hBMSCs into chondrocytes; and the hydrogel grafted with RGD and QK peptide facilitates chondrocyte hypertrophy, which creates a vascularized niche for osteogenesis and finally accelerates osteochondral repair in vivo. The findings provide an efficient bioengineering approach by sequentially modulating cellular ECO behavior for osteochondral defect repair.

Anatomy and clinical application of suprascapular nerve to accessory nerve transfer.

BACKGROUND: Loss of motor function in the trapezius muscle is one complication of radical neck dissection after cutting the accessory nerve (AN) during surgery. Nerve repair is an effective method to restore trapezius muscle function, and includes neurolysis, direct suture, and nerve grafting. The suprascapular nerve (SCN) and AN are next to each other in position. The function of the AN and SCN in shoulder elevation and abduction movement is synergistic. SCN might be considered by surgeons for AN reanimation. AIM: To obtain anatomical and clinical data for partial suprascapular nerve-to-AN transfer. METHODS: Ten sides of cadavers perfused with formalin were obtained from the Department of Human Anatomy, Histology and Embryology, Peking University Health Science Center. The SCN (n = 10) and AN (n = 10) were carefully dissected in the posterior triangle of the neck, and the trapezius muscle was dissected to fully display the accessory nerve. The length of the SCN from the origin of the brachial plexus (a point) to the scapular notch (b point) and the distance of the SCN from the origin point (a point) to the point (c point) where the AN entered the border of the trapezius muscle were measured. The length and branches of the AN in the trapezius muscle were measured. A female patient aged 55 years underwent surgery for partial SCN to AN transfer at Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology. The patient suffered from recurrent upper gingival cancer. Radical neck dissection was performed on the right side, and the right AN was removed at the intersection between the nerve and the posterior border of the SCM muscle. One-third of the diameter of the SCN was cut off, and combined epineurial and perineurial sutures were applied between the distal end of the cut-off fascicles of the SCN and the proximal end of the AN without tension. Both subjective and objective evaluations were performed before, three months after, and nine months after surgery. For the subjective evaluation, the questionnaire included the Neck Dissection Impairment Index (NDII) and the Constant Shoulder Scale. Electromyography was used for the objective examination. Data were analyzed using t tests with SPSS 19.0 software to determine the relationship between the length of the SCN and the linear distance. A P value of < 0.05 was considered as statistically significant. RESULTS: The whole length of the AN in the trapezius muscle was 16.89 cm. The average numbers of branches distributed in the descending, horizontal and ascending portions were 3.8, 2.6 and 2.2, respectively. The diameter of the AN was 1.94 mm at the anterior border of the trapezius. The length of the suprascapular nerve from the origin of the brachial plexus to the scapular notch was longer than the distance of the suprascapular nerve from the origin point to the point where the accessory nerve entered the upper edge of the trapezius muscle. The amplitude of trapezius muscle electromyography indicated that both the horizontal and ascending portions of the trapezius muscle on the right side had better function than the left side nine months after surgery. The results showed that the right-sided supraspinatus and infraspinatus muscles did not lose more function than the left side. CONCLUSION: Based on anatomical data and clinical application, partial suprascapular nerve-to-AN transfer could be achieved and may improve innervation of the affected trapezius muscle after radical neck dissection.

Study on the reconstruction of a four-dimensional movement model and the envelope surface of the condyle in normal adults.

The objective of this study was to reconstruct the envelope surface of the condyle and the four-dimensional trajectory model in mandibular border movement in normal adults. Eleven healthy subjects were selected as volunteers. Cone-beam computed tomographic (CBCT) scanning was performed on the volunteers. The three-dimensional (3D) movement path of the mandible was recorded using a virtual articulator (PN-300), which was based on a 3D model of the mandible. We used Proplan CMF 3.0 (Materialise) software to perform this from the DICOM data generated by CBCT scans. The distance of condylar movement was measured in this model during volunteers' mouth opening, protrusion, and lateral excursions. The envelope surface of the condyle was reconstructed by merging a functional condylar surface at each recording moment during the movement of the whole border. In the mandibular digital models, the condyle moved downward firstly, and moved upward to the position of maximum mouth opening. The condyle moved forward and downward during protrusion. The working condyle rotated slightly and the non-working condyle moved forward, downward, and inward during lateral excursions. The mean (SD) movement distance of 11 subjects was 19.04 (4.37) mm during mouth opening (including downward and upward) and 9.75 (2.38) mm during protrusion. During lateral excursions the mean (SD) movement distance of the working condyle was 2.87 (1.13) mm, the mean (SD) movement distance of the non-working condyle was 10.85 (3.25) mm. The envelope surface of healthy volunteers showed a double-peak pattern. The envelope surface of the condyle and four-dimensional movement model can be reconstructed by merging the trajectory of the mandible recorded from the novel virtual articulator PN300 and a 3D image of the mandible.

Three-dimensional radiological anatomy of condyle trabecular bone based on a Volume-of-Interest analysis.

OBJECTIVES: Three-dimensional radiological anatomic characteristics of condyle trabeculae was obtained quantitatively based on a volume-of-interest (VOI) analysis. METHODS: Nine human mandibular condyle specimens were scanned by micro-computed tomography (micro-CT). A total of 34 VOIs were selected from each condyle specimen, which were divided into six layers and four parts to analyze the morphological characteristics of trabeculae based on cylindrical VOIs with a diameter and height of 2 mm. One-way analysis of variance was used to compare the regional differences of morphological parameters among each layer and part. RESULTS: Values for bone mineral density, bone volume/total volume, trabecular thickness, and trabecular bone number were greater in the anterior part compared with the posterior part; and the lateral part was larger than the medial part in the first, second, and third layers, while the medial part was larger in the fourth and fifth layers; these values in the first and sixth layers were much larger, while those in the third and fourth layers were smaller. Bone surface area/bone volume, trabecular spacing, and trabecular bone pattern factor were larger in the posterior part than in the anterior part; and the lateral part was larger than the medial part in the fourth and fifth layers, while the medial part was larger in the first and second layers. CONCLUSIONS: The morphological distribution of VOIs was anisotropic within trabecular bone of human mandibular condyles. The upper and lower ends of trabecular bone were much more compact, with higher bone density, trabecular thickness, and trabecular number than in the middle layers.

Biomechanical comparison between the custom-made mandibular condyle prosthesis and total temporomandibular joint prosthesis in finite element analysis.

PURPOSE: The purpose of this study was to compare the biomechanical behavior of the custom-made mandibular condyle prosthesis and total TMJ prosthesis. METHODS: Three models of one beagle dog, the condyle prosthesis (Model 1, replacing the right condyle only), the TMJ prosthesis (model 2, replacing the whole right TMJ) and the intact TMJ (model 3) were established, and the mechanical responses under muscle forces loading were analyzed using finite element method. RESULTS: Models 1 and 3 had the similar stress distribution on the right disc, which suggested that the condyle prosthesis did not change the disc stress so much when the muscle forces were applied. The stress of the right TMJ prosthesis in Model 2 was larger than both Models 1 and 3, and the stress of the contralateral TMJ reduced by 12% in Model 2. The anterior border of the condyle seemed to be a stress concentration region, not only for the intact condyle, but also for the condyle prosthesis and the total TMJ prosthesis. CONCLUSIONS: The total TMJ prosthesis changed the biomechanical balance of the bilateral TMJ. When the condyle prosthesis iss applied, the custom-made profile is recommended.

Application of an acellular dermal matrix to a rabbit model of oral mucosal defects.

Acellular dermal matrices (ADMs) are increasingly used for the restoration of soft-tissue defects of the oral cavity due to their ability to facilitate faster healing and reduce scar formation without rejection. However, few studies have focused on the histopathology and biological mechanisms involved in their use. The aim of the present study was to observe tissue growth, histopathologic changes and altered biomolecular signatures that occur during the repair of oral defects in rabbit models over time, either with or without the employment of ADM. Animals were sacrificed 1, 2 and 4 weeks following surgery and histological changes were evaluated using hematoxylin and eosin staining. Reverse transcription-polymerase chain reaction and western blot analysis were used to determine changes in the expression of vascular endothelial growth factor (VEGF) and glucose transporter 1 (GLUT1). It was demonstrated that wounds treated with ADM exhibited a weak inflammatory reaction and faster epithelialization and revascularization compared with untreated wounds. This may have been caused by the elevated levels of VEGF and GLUT1 protein detected in the ADM-treated defects. Thus, treating wounds of the oral mucosa with an ADM improves pathological responses compared with those with an untreated wound. The current study demonstrates the underlying mechanisms by which ADM promotes wound healing in defects of the oral mucosa and the results provide further evidence for the use of ADM in clinical settings for the repair of mucosal defects.

A custom-made temporomandibular joint prosthesis for fabrication by selective laser melting: Finite element analysis.

A novel and custom-made selective laser melting (SLM) 3D-printed alloplastic temporomandibular joint (TMJ) prosthesis is proposed. The titanium-6aluminium-4vanadium (Ti-6Al-4V) condyle component and ultra-high molecular weight polyethylene (UHMWPE) fossa component comprised the total alloplastic TMJ replacement prosthesis. For the condyle component, an optimized tetrahedral open-porous scaffold with combined connection structures, i.e. an inlay rod and an onlay plate, between the prosthesis and remaining mandible was designed. The trajectory of movement of the intact condyle was assessed via kinematic analysis to facilitate the design of the fossa component. The behaviours of the intact mandible and mandible with the prosthesis were compared. The biomechanical behaviour was analysed by assessing the stress distribution on the prosthesis and strain distribution on the mandible. After muscle force was applied, the magnitude of the compressive strain on the condyle neck of the mandible with the prosthesis was lower than that on the condyle neck of the intact mandible, with the exception of the area about the screws; additionally, the magnitude of the strain at the scaffold-bone interface was relatively high.

An Anatomical Study of Maxillary-Zygomatic Complex Using Three-Dimensional Computerized Tomography-Based Zygomatic Implantation.

OBJECTIVE: To obtain anatomical data of maxillary-zygomatic complex based on simulating the zygomatic implantation using cadaver heads and three-dimensional computerized tomography (3D-CT). METHODS: Simulating zygomatic implantation was performed using seven cadaver heads and 3D-CT images from forty-eight adults. After measuring the maxillary-zygomatic complex, we analyzed the position between the implantation path and the maxillary sinus cavity as well as the distance between the implantation path and the zygomatic nerve. RESULTS: The distance from the starting point to the endpoint of the implant was 56.85 ± 5.35 mm in cadaver heads and 58.15 ± 7.37 mm in 3D-CT images. For the most common implantation path (80.20%), the implant went through the maxillary sinus cavity completely. The projecting points of the implant axis (IA) on the surface of zygoma were mainly located in the region of frontal process of zygomatic bone close to the lateral orbital wall. The distances between IA and zygomatic nerve in 53 sides were shorter than 2 mm. CONCLUSION: The simulating zygomatic implantation on cadaver skulls and 3D-CT imaging provided useful anatomical data of the maxillary-zygomatic complex. It is necessary to take care to avoid the zygomatic nerve injury during implantation, because it frequently appears on the route of implantation.

Mesenchymal stem cells derived from normal gingival tissue inhibit the proliferation of oral cancer cells in vitro and in vivo.

The interplay between tumor cells and mesenchymal stem cells (MSCs) within tumor microenvironment plays a significant role in tumor development, and thus might be exploited for therapeutic intervention. In this study, we isolated MSCs from normal gingival tissue (GMSCs), and detected the effect of GMSCs on oral cancer cells via direct co-culture and indirect co-culture systems. The cell proliferation assay of direct co-culture showed that GMSCs could inhibit the growth of oral cancer cells. Conditioned medium derived from GMSCs (GMSCs-CM) also exerted an anticancer effect, which indicates that soluble factors in GMSCs-CM played a dominant role in GMSCs-induced cancer cell growth inhibition. To investigate the mechanism, we performed apoptosis assay by flow cytometry, and confirmed that cancer cell apoptosis induced by GMSCs could be a reason for the effect of GMSCs on the growth of oral cancer cells. Western blotting also confirmed that GMSCs could upregulate expression of pro-apoptotic genes including p-JNK, cleaved PARP, cleaved caspase-3, Bax expression and downregulate proliferation- and anti-apoptosis-related gene expression such as p-ERK1/2, Bcl-2, CDK4, cyclin D1, PCNA and survivin. Importantly, the inhibitory effect of GMSCs on cancer cells can partially be restored by blockade of JNK pathway. Moreover, animal studies showed that GMSCs exerted an anticancer effect after oral cancer cells and GMSCs were co-injected with oral cancer cells. Taken together, our data suggest that GMSCs can suppress oral cancer cell growth in vitro and in vivo via altering the surrounding microenvironment of oral cancer cells, which indicates that GMSCs have a potential use in the management of oral dysplasia and oral cancer in future.

[Influence of acellular dermal matrix on differentiation of stem cells from young permanent tooth apical papilla].

OBJECTIVE: To get the stem cells from the young permanent tooth apical papillae, and observe the osteogenic differentiation of the cells after cultured with acellular dermal matrix (ADM). METHODS: Young permanent tooth apical papillae were obtained by the oral surgeon. The cells from the apical papillae were isolated, cultured and analyzed through a flow cytometer. The cells in the experimental group were induced both osteogenic and adipogenic differentiation. The cells were not induced in the control group.Both groups were evaluated by staining and real-time polymerase chain reaction (real-time PCR) to examine the quantity of RNAs in the experimental group. The cells from apical papillae were also cultured with ADM. These cells were also induced both osteogenic and adipogenic differentiation in the experimental group, and not induced in the control group. The measures of staining and real-time PCR were also carried out. RESULTS: The cells from the apical papillae proliferated in a rapid rate. Of which 70.3% in cultures were positive for Stro-1, and 96% positive for CD105 according to flow cytometric analysis. After induction, the RNA level related to osteogenic and adipogenic differentiation expressed higher in the experimental group than those of the control group without induction obviously, such as osteocalcin (OCN), bone sialoprotein (BSP), liver X-recepter α (LXRα), lipoprotein lipase(LPL), peroxisome proliferator activated receptor γ (PPAR-γ), and scavenger receptor class B type 1(SR-B1). The cells cultured with ADM also had a fast proliferation, and grew attached to ADM. After induction, the RNA level of OCN and BSP had a higher expression than the control group (P > 0.05), and LPL also expressed higher (P < 0.05). CONCLUSION: The study approved that there were a big amount of stem cells in the young permanent tooth apical papilla obtained by oral surgery, which had significant osteogenic potential. The cells still proliferated well when they were cultured with ADM as a kind of collagen skelecton. The results showed that ADM could be performed as a base to support the stem cells to survive the environment, and it also could play a role in osteogenic differentiation of stem cells from apical papilla.

[Application of Dextroscope virtual reality in anatomical research of the mandible part of maxillary artery].

OBJECTIVE: To evaluate the application of virtual reality technology in anatomical study of the mandible part of the maxillary artery and to provide anatomical basis in case of intraoperative damage. METHODS: The experiment was divided into two groups, virtual group and corpus group, 15 cases in each group. In virtual group, images data of cadaver heads were loaded into Dextroscope workstation and dissecting of mandible part of the maxillary artery was simulated. In corpus group, actual dissecting on the cadaver heads was examined under microscope correspondingly. RESULTS: The distance from the maxillary artery to posterior margin of the ramus, to sigmoid notch, to apex of condyle, to the apex of the articular eminence, and the distance from the starting point of the maxillary artery to apex of condyle and the diameter of the starting point of the maxillary artery were (6.12 ± 0.78)mm, (5.29 ± 0.69)mm, (20.68 ± 0.95)mm, (4.60 ± 0.60)mm, (22.48 ± 1.18)mm, (3.74 ± 0.57)mm in corpus group and (6.22 ± 0.63)mm, (5.40 ± 0.51)mm, (20.80 ± 0.88)mm, (4.55 ± 0.56)mm, (22.70 ± 1.11)mm, (3.69 ± 0.60)mm in virtual group. CONCLUSION: The data measured in virtual group was highly coincided with the data in corpus group verified by statistics. Virtual anatomy of the mandible part of the maxillary artery by virtual reality technology is reliable.

The effect of cultured autologous periodontal ligament cells on the healing of delayed autotransplanted dog's teeth.

INTRODUCTION: The regeneration of the periodontal structure for avulsed teeth extended dry times has been a goal of dentists. The aim of this study was to investigate a new strategy of delayed replantation for avulsed teeth that were not suitable for immediate replantation. METHODS: Extracted dog's premolar teeth were maintained in a dry environment for a month after isolation and proliferation of the periodontal ligament (PDL) cells. Then, tooth roots coated with 1 x 10(6) cultured autologous PDL cells were autotransplanted in artificial sockets created in the mandible. The dogs were sacrificed 60 days after transplantation. Histologic analyses showed that a root-PDL-bone complex was found in all cases of the PDL cell-loaded samples. RESULTS: The new PDL-like connective tissue was located between the alveolar bone and the transplanted roots, with fibers inserting into the newborn cementum on one end and alveolar bone on the other. For the control samples, no PDL-like tissue was found, and ankylosis was commonly observed. CONCLUSIONS: The results indicated that cultured autologous PDL cells assist in the re-establishment of periodontal architecture of autotransplanted teeth that is devoid of viable periodontal cells.