Analysis of 256 pediatric oral and maxillofacial emergency in-patients during the outbreak of COVID-19.

BACKGROUND/AIMS: Pediatric oral and maxillofacial surgeons have faced severe challenges in ward management due to their high risk of exposure during the COVID-19 epidemic. The aim of this study was to analyze and summarize the treatment methods and infection prevention and control measures applied in emergency cases in the Department of Pediatric Oral and Maxillofacial Surgery, Children's Hospital of Chongqing Medical University, during the COVID-19 epidemic. METHODS: In this retrospective study, information was collected from 256 pediatric emergency patients who were treated from January 23, 2020 to August 9, 2021. The patients' data were statistically analyzed according to age, gender, disease and pathogenesis, operation time, and the main treatment applied in pediatric oral and maxillofacial emergency cases during the COVID-19 epidemic. RESULTS: During the epidemic period, 256 pediatric emergency patients were successfully treated. Among them, there were 170 boys and 86 girls. In all, 182 patients were diagnosed with oral or facial lacerations; 43 had jaw fractures; 26 had maxillofacial infections; and five had dento-alveolar fractures. A total of 246 patients underwent surgery under negative pressure with level 3 protection standards. No doctors or patients infected with COVID-19 were found throughout the stury period. CONCLUSIONS: Pediatric oral and maxillofacial emergency in-patients mainly experienced maxillofacial trauma during the COVID-19 epidemic, followed by infection. Effective diagnosis and treatment, and avoidance of COVID-19 infection can be achieved by strictly following epidemic prevention and treatment procedures.

[Diagnosis and treatment of congenital submandibular duct dilatation].

OBJECTIVE: To study the clinical features and treatments of congenital submandibular duct dilatation. METHODS: Seven children with congenital submandibular duct dilatation from January 2008 to March 2018 were included in this study, whose average age was 5 months and 22 days. The clinical manifestations are unilateral swelling of the mouth floor. All seven children underwent sublingual gland resection, submandibular gland dilatation catheter resection, and catheter reroute under general anesthesia. Intraoperatively, the orifice of the submandibular gland was constricted and part of the catheter was dilated. RESULTS: All seven patients had good healing without swelling or cyst formation. CONCLUSIONS: Congenital submandibular duct dilatation occurs at a young age. Early diagnosis and treatment can help prevent further expansion of the catheter and avoid gland atrophy, feeding difficulty, and breathing obstruction. Simultaneous excision of the sublingual gland can avoid the formation of postoperative sublingual cyst.

[Study on the in vitro effects of dexamethasone at different concentrations on the growth of murine embryonic palatal mesenchymal cell].

OBJECTIVE: To observe the effect of dexamethasone on the proliferation and apoptosis of embryonic palatal mesenchymal (EPM) cells, and chose a proper concentration of dexamethasone which can effect the ordinary growth of embryonic palatal mesenchymal cells. METHODS: The primary EPM cells were isolated and cultured in vitro, then we did biological assay. EPM cells were treated with different concentration dexamethasone (1 x 10(-9), 1 x 10(-8), 1 x 10(-7) and 1 x 10(-6) mol x L(-1)) respectively. The proliferation of EPM cells was evaluated using MTT method. Apoptosis was examined quantitatively with fluorescein stain. RESULTS: In the condition of blood serum's concentration at 10%, optical density step down following the raise of dexamethasone's concentration. The effect of dexamethasone got to a summit at 3 days. Inhibition rate of dexamethasone at 1 x 10(-6) mol x L(-1) was the highest. CONCLUSION: Dexamethasone at 1 x 10(-6) mol x L(-1) can not only inhibit the growth of the EPM cells, but also will not lead to a large number of cells death. Therefore, this concentration can be used as a reference standard in future research. The most significant drug action time of dexamethason appears at the third day after administration, then the effect became weaken following the drug metabolism.

A comparative study of fluctuating asymmetry in Chinese families with nonsyndromic cleft palate.

OBJECTIVE: To compare the asymmetry displayed by Chinese patients with nonsyndromic cleft palate (NSCP), their unaffected parents, and a control population. METHOD: With rigorous inclusion criteria, a total number of 675 individuals with NSCP, 675 parental pairs of these patients, and 650 control individuals were involved in this case-control study. Size-adjusted fluctuating asymmetry (FA) scores were calculated by data on 10 variables. Analysis of variance was used for a three-way comparison of patients/gender-matched parents/gender-matched controls. RESULTS: A significant increase in FA for ear length (p<.05) was noted in NSCP patients when compared with their gender-matched parents. A significant increase in FA for ear length and palpebral fissure width (p<.05) was observed in NSCP patients when compared with the gender-matched control population. A significant increase in FA for palpebral fissure width (p<.05) was detected in parents of NSCP patients when compared with a gender-matched control population. CONCLUSION: Our results indicated that, when compared with a gender-matched control population, patients with NSCP show significantly increased FA in both ear length and palpebral fissure width, but the parents of patients with NSCP show significantly increased FA only in palpebral fissure width. In general, these characteristics seem to be more distinct in male individuals.

Animal experimental study on repairing alveolar clefts by using rectilinear distraction osteogenesis.

The aim of this study was to evaluate the clinical applicability of rectilinear distraction osteogenesis for repairing alveolar cleft models. Alveolar process distraction surgery to produce bilateral clefts was performed on six adult cats. In our study, the left side with the distraction device was the experimental side, and the other side without a distraction device was the control side. After a 6-day latent period, animals underwent gradual distraction at a rate of 0.6mm per day (distraction was performed twice each day, at a rate of 0.3mm each time), until the tissue on the two sides of the cleft touched, then the distraction strength was maintained for 2 days. Two cats were sacrificed at 2 weeks, 6 weeks and 10 weeks postoperatively. Gross anatomical, histological and radiographical analyses were performed after the animals were sacrificed. In addition, the arch width was measured both before setting the distraction device and after distraction was complete. Two weeks after the distraction was complete, the soft tissue of the two sides of the cleft region on the experimental side touched, and it began to coalesce. The extremities of the two sides of the cleft region on all the experimental sides drew close to each other, but there was no bony conjunction. New bone formation appeared in the distraction region. The arch width at the front of the maxillary bone on the distraction side after distraction was smaller than before distraction. The alveolar cleft could be closed by rectilinear distraction osteogenesis. Two sides of the cleft touched each other and only soft tissue coalesced, but we did not observe bone coalescing. This phenomenon suggested that it might be difficult to achieve complete bony repair by rectilinear distraction osteogenesis. However, rectilinear distraction osteogenesis can minimise the size of the alveolar cleft and make bone grafting advisable for those patients who are not suitable for bone grafting before distraction osteogenesis.

Effects of different types of palatal lateral excisions on growth and development of maxilla and dental arch.

OBJECTIVE: This study aimed to explore the effects of different types of palatal lateral excisions on the growth and development of the maxilla and dental arch, and to investigate the underlying mechanisms. METHODS: A total of 112 3-week-old Sprague-Dawley (SD) male rats were randomly divided into a control and 3 experimental groups: the mucoperiosteal denudation group, the mucosal flap excision group, and the periosteum excision group. In the experimental groups, bilateral mucoperiosteal, mucosal flap and periosteum were excised respectively in the lateral one half of the palate. Four rats in each group were randomly chosen for sacrifice every two weeks. The maxilla was dissected following the excision. The widths of the maxilla and dental arch were measured and the histological phenomena were investigated at different phases. At the same time, 12 animals in each group were sequentially injected with calcein every two weeks. Three animals in each group, whose fluorescent labeling was used, were sacrificed for investigating bone formation at Week 8 following injection. RESULTS: (1) Each experimental group presented the constriction of the maxilla and dental arch. The upper first molars in the experimental groups inclined medially. The mucoperiosteal denudation group showed the largest degree of effect followed by the periosteum excision group. The indices of the mucosal flap excision group, which retained the structures of the periosteum layer, had the most approximate values to the control group; (2) Different histological changes among the experimental groups were detected. The fibers penetrated into the palatal bone as Sharpey's fibers in the mucoperiosteal denudation group. The pattern of bone deposition was the bundle type. Sharpey's fibers were not found in the mucosal flap and periosteum excision groups and the depositions of palatal bone were the lamellar type as those in the control group; (3) The rates of bone deposition in the experimental groups decreased compared with the control group. The rates in different phases were the most approximate values to those of the control group in the mucosal flap excision group, which has the same structure of periosteum as the control group. CONCLUSION: There were different effects on the growth and development of the maxilla and dental arch in different types of palatal lateral excisions. Periosteum is important for bone formation and deposition pattern. The prevention of Sharpey's fibers forming and attaching to the palatine can effectively avert the following malformation.