ABSTRACT
To retrospectively review the clinical effect of comprehensive treatment of alveolar cleft (CTAC) using the mandible as the bone source. Patients with alveolar clefts who met the inclusion criteria were subjected to a CTAC protocol that included the following: (1) preoperative orthodontic treatment for creating good soft-tissue conditions; (2) 'area-like grafting' with subperiosteal osteogenic chin bone instead of cartilaginous osteogenic iliac bone; (3) simulation of normal bone anatomy via a sandwich-like bone graft consisting of 'cortical bone + cancellous bone + cortical bone'; and (4) strong internal fixation to ensure initial bone block stability. At 6 months postoperatively, the titanium plate was removed and cone-beam computed tomography was performed to evaluate the surgical results. A total of 54 patients underwent treatment with the CTAC protocol. The average age at the initial operation was 10.3 ± 2.1 years, and the average hospital stay was 2.8 ± 0.6 days. At 6 months postoperatively, 49 patients (90.7%) showed good clinical results. The transplanted bone block formed a 'cortical bone + cancellous bone + cortical bone' structure similar to that of the normal jawbone. A mature bone bridge formed, and the impacted permanent teeth continued to erupt and enter the bone graft area. CTAC is a comprehensive restorative solution for alveolar cleft repair that integrates multiple concepts, including orthodontics, embryology, anatomy, and improvements to surgical methods. The method is easy to perform, causes little surgical trauma, and shows a stable success rate, and is thus worth promoting.
Subject(s)
Alveolar Bone Grafting , Cleft Lip , Cleft Palate , Humans , Retrospective Studies , Cleft Lip/surgery , Cancellous Bone , Treatment Outcome , Cleft Palate/diagnostic imaging , Cleft Palate/surgery , Bone Transplantation/methods , Mandible , Alveolar Bone Grafting/methodsABSTRACT
BACKGROUND: The nucleotide-binding oligomerization domain-like receptor pyrin domain containing 3 (NLRP3) inflammasome signaling pathway is a highlighted topic in the field of inflammation. However, there is little research on the relationship between the NLRP3 inflammasome pathway and temporomandibular joint osteoarthritis (TMJOA). The aim of this study was to examine the expression of inflammatory mediators related to the NLRP3 inflammasome in the synovial fluid of patients with condylar cartilage degeneration and verify the clinical effects of sodium hyaluronic acid (HA) treatment on TMJOA. METHODS: Patients diagnosed with temporomandibular joint internal derangement (TMJID) without condylar defects and TMJOA with condylar defects were divided into two groups. There were thirty patients in each group, and inflammatory mediators related to the NLRP3 inflammasome, including interleukin-1 beta (IL-1ß), IL-18, NLRP3, and cysteinyl aspartate specific proteinase 1 (CASP1), in synovial fluid were measured by enzyme-linked immunosorbent assay (ELISA). Eighteen patients in the TMJOA group were retested after two HA treatments to evaluate the therapeutic effects of HA. RESULTS: IL-1ß, IL-18, NLRP3 and CASP1 were all positive in the two groups, and TMJOA patients with condylar defects had higher expression of these molecules than TMJID patients (P < 0.05). IL-1ß, IL-18, and NLRP3 were decreased after two HA treatments (P<0.05), but there was no significant difference in CASP1 after two HA injections (P = 0.549). CONCLUSIONS: The NLRP3 inflammasome signaling pathway may be involved in condylar degeneration. HA could reduce some inflammatory molecules to alleviate inflammation.
Subject(s)
NLR Family, Pyrin Domain-Containing 3 Protein , Osteoarthritis , Humans , Inflammation Mediators , Interleukin-1beta , Osteoarthritis/diagnosis , Osteoarthritis/drug therapy , Synovial Fluid , Temporomandibular JointABSTRACT
The propagation and combination of surface plasmon polaritons (SPPs) in Y-shaped metallic nanochannels are investigated numerically via finite difference time domain (FDTD). It is shown that the behavior of SPPs in nano-size channels resembles that of light guiding in conventional waveguides, and SPPs can also be combined effectively with appropriately designed structures. The loss associated with metal absorption and scattering with the multiple reflections between slit openings on the bend angle are analyzed numerically. The Fabry-Perot cavity effect displayed by SPPs traveling in channels with finite length is discussed as well.
