Cost-effectiveness of cytomegalovirus vaccination for females in China: A decision-analytical Markov study.

BACKGROUND: The global burden of disease caused by congenital cytomegalovirus (CMV) infection is high. Previous modeling studies have suggested that CMV vaccination may be cost-effective in developed countries. Congenital CMV infection is more likely driven by maternal non-primary infection in China. We aimed to measure the effectiveness and cost-effectiveness of population-level CMV vaccination in Chinese females. METHODS: A decision tree Markov model was developed to simulate potential CMV vaccination strategies in a multi-cohort setting, with a population size of 1,000,000 each for the infant, adolescent (10-year-old) and young adult (20-year-old) cohorts. The hypothetical vaccines were assumed to have 50% efficacy, 20 years of protection, 70% coverage, at a price of US$120/dose for base-case analysis. Costs and disability-adjusted life years (DALYs) were discounted by 3% per year and the vaccination would be considered cost-effective if an incremental cost-effectiveness ratio (ICER) was lower than 2021 Chinese per capita GDP (US$12,500). FINDINGS: For the pre-infection (PRI) vaccine efficacy type, the adolescent strategy was the most cost-effective, with an ICER of US$12,213 (12,134 to 12,291) pre DALY averted, compared with the next best strategy (young adult strategy). For pre- and post-infection (P&PI) efficacy type, the young adult strategy was the most cost-effective as it was cost-saving. In one-way analysis varying the PRI vaccine price, the infant strategy, adolescent strategy and the young adult strategy would be a dominant strategy over others if the vaccine cost ≤US$60, US$61-121 and US$122-251 per dose respectively. In contrast, the young adult strategy continued to be the preferred strategy until the P&PI vaccine price exceeded US$226/dose. Our main results were robust under a wide variety of sensitivity analyses and scenario analyses. INTERPRETATION: CMV vaccination for females would be cost-effective and even cost-saving in China. Our findings had public health implications for control of CMV diseases.

[Clinical effect of simultaneous implantation and maxillary sinus floor elevation with or without bone graft].

PURPOSE: To investigate the difference of osteogenic effect and stability of maxillary sinus implants 6 months after maxillary sinus elevation with or without bone grafting. METHODS: A total of 150 patients with maxillary sinus floor lift and simultaneous implantation in Lishui People's Hospital from December 2019 to December 2021 were divided into group A (internal maxillary sinus lift + bone grafting) and group B (internal lift without bone grafting). Preoperative and postoperative CBCT data and implant stability of all patients were measured and analyzed to compare whether there were differences in clinical efficacy between the two groups. SPSS 25.0 software package was used for data analysis. RESULTS: A total of 199 implants were implanted, the implant retention rate was 97.6% in group A and 95.7% in group B one year after surgery, with no significant difference between the two groups(P＞0.05). There was no significant difference in residual bone height(RBH) and gray scale value (HU) between the two groups before and 6 months after operation (P＞0.05). There was no significant difference in ISQ value between the two groups during operation and 6 months after operation(P＞0.05). CONCLUSIONS: In cases with the remaining alveolar bone height of 3～8 mm and the planned lifting height of 3～4 mm, maxillary sinus floor lifting procedure achieved good clinical results in both groups with or without bone grafting, which indicated that bone grafting had little effect on retention rate and stability of the implants.

Clinical esthetic comparison between monolithic high-translucency multilayer zirconia and traditional veneered zirconia for single implant restoration in maxillary esthetic areas: Prosthetic and patient-centered outcomes.

Background/purpose: Clinical esthetic evidence for the performance of monolithic high-translucency multilayer zirconia is lacking. The aim of this study was to compare monolithic high-translucency multilayer zirconia with traditional veneered zirconia in clinical situation. Material and methods: A total of 30 participants who were provided with both monolithic zirconia crowns (Group 1) and traditional veneered crowns (Group 2) for single implant restoration in maxillary esthetic areas were enrolled. Patients' subjective outcome (Visual Analog Scale, VAS) were recorded. Photos were taken and then evaluated by 9 evaluators with Pink and White Esthetic Score (WES). Wilcoxon signed rank test was used for comparison between Group 1 and Group 2 in VAS, WES and five variables in WES. Kendall's coefficient of concordance test was used to calculate inter-rater reliability of WES variables. Spearman correlation was used to analyze association between patients' outcome and evaluators' scores. Results: There was no significant difference in patients' subjective outcome between monolithic zirconia and traditional veneered crowns: overall VAS were 9.0 (8.0-9.0) and 9.0 (8.5-9.5), respectively (P > 0.05). However, in professional view, significant difference between Group 1 and Group 2 in WES was observed: 7.5 (6.0-8.0) and 8.0 (6.5-8.5), respectively (P < 0.05). Kendall's test showed, among WES variables, translucency demonstrated the highest agreement. Professionally reported evaluations did not correlate with patient-reported outcomes (Spearman correlation were 0.246 and 0.224 for Group 1 and Group 2, respectively). Conclusion: Within the limitation of this study, it can be concluded that monolithic high-translucency multilayer zirconia restoration might be a treatment modality.

[Effect of rat allogeneic BMSCs-Bio-Oss-bFGF compound on tooth extraction healing: a micro-CT study].

PRUPOSE: To investigate the effect of a compound of BMSCs-Bio-Oss-bFGF on microstructure of extraction sockets in rats. METHODS: Bone mesenchymal stem cells (BMSCs) were isolated from bone marrow of 3-week SD rats by adherent method. Maxillary posterior teeth of 36 6-week SD rats were extracted and materials were implanted into sockets according to grouping. The rats were divided into 4 groups: compound group with implanting BMSCs-Bio-Oss-bFGF compound, powder group with implanting Bio-Oss, BMSCs group with implanting BMSCs, and control group without implanting any materials. The sockets were scanned by micro-CT 4 weeks, 12 weeks and 24 weeks after implantation. Two-way ANOVA was used to assess whether there was significant difference between groups with GraphPad Prism 6.0 software package. RESULTS: There was no significant difference among groups in bone mineral density (BMD), trabecular separation(Tb.Sp), trabecular thickness(Tb.Th), degree of anisotropy(DA), and trabecular number(Tb.N) 4 weeks after implantation. By 12 weeks, BMD of compound group was significantly greater than those of BMSCs group, powder group and control group (P＜0.05), and significantly greater than those of powder group and control group at 24 weeks (P＜0.05). Tb.Th of compound group was significantly greater than that of BMSCs group at 12 and 24 weeks(P＜0.05). DA had no significant difference among groups at 4, 12, and 24 weeks (P＞0.05). Tb.Sp of compound group was significantly smaller than those of powder group, BMSCs group and control group at 24 weeks(P＜0.05). Tb.N of compound group was significantly greater than those of BMSCs group and control group(P＜0.05). CONCLUSIONS: The compound of rat allogeneic BMSCs-Bio-Oss-bFGF improves socket healing.

[TAN Bayesian network modeling of online learning decision making of dental undergraduates during the COVID-19 pandemic].

PURPOSE: To perceive the dental undergraduate's policy of coping with online learning and their decision-making laws during the COVID-19 pandemic. METHODS: For dental undergraduate students from the 2016 grade to 2018 grade of Lishui University, two prospective questionnaire surveys were conducted before the online course starting and four weeks later. SPSS Modeler18.0 software was used to screen, review, and analyze the data. TAN (tree augmented naive) Bayesian network models were utilized to analyze and predict variables. Indicators like the overall prediction accuracy, receiver operating characteristic curve (ROC curve), and area under the ROC curve(AUC value) were applied to evaluate the model's predicting performances. RESULTS: The case score of each survey was 422 and 382, and the Cronbach's α coefficients of internal consistency were 0.91 and 0.82. Among the decision-making variables in the aspect of "whether to preview online learning materials", the top-two variables were "looking forward to the semester beginning" and "the validity of the network materials". In speaking of "whether the online courses meet the offline course standards", the top-three variables were "the rhythm of lecturing on live or in recorded videos", "how many online tasks', and" the data frame and organization". The overall prediction accuracy of each constructed TAN Bayesian network model was 89.42% and 87.82%, and their AUC values were 0.75 and 0.93, respectively. CONCLUSIONS: To truly make online courses comparable to the off-line curriculum, teachers should fully understand how the students cope with their online learning at first. Then, only by perceiving and recognizing the students' expectations for education, by efficiently preparing and organizing online materials with all-round, clearly-structured, vivid, comprehensible contents and moderate difficult tasks, by well interacting with students through different websites and social media, can we truly achieve " ongoing learning with suspended class".

Assessment of Hearing Screening Combined With Limited and Expanded Genetic Screening for Newborns in Nantong, China.

Importance: Early identification and intervention for newborns with hearing loss (HL) may lead to improved physiological and social-emotional outcomes. The current newborn hearing screening is generally beneficial but improvements can be made. Objective: To assess feasibility and evaluate utility of a modified genetic and hearing screening program for newborn infants. Design, Setting, and Participants: This population-based cohort study used a 4-stage genetic and hearing screening program at 6 local hospitals in Nantong city, China. Participants were newborn infants born between January 2016 and June 2020 from the Han population. Statistical analysis was performed from April 1 to May 1, 2021. Exposures: Limited genetic screening for 15 variants in 4 common HL-associated genes and newborn hearing screening (NHS) were offered concurrently to all newborns. Hearing rescreening and/or diagnostic tests were provided for infants with evidence of HL on NHS or genetic variants on screening. Expanded genetic tests for a broader range of genes were targeted to infants with HL with negative results of limited genetic tests. Main Outcomes and Measures: The detection capability for infants with hearing impairment who passed conventional hearing screening, as well as infants with normal hearing at risk of late-onset HL due to genetic susceptibility. Results: Among a total of 35 930 infants, 32 512 infants completed the follow-up and were included for analysis. Among the infants included in the analysis, all were from the Han population in China and 52.3% (16 988) were male. The modified genetic and hearing screening program revealed 142 cases of HL and 1299 cases of genetic variation. The limited genetic screening helped identify 31 infants who passed newborn hearing screening, reducing time for diagnosis and intervention; 425 infants with normal hearing with pathogenic SLC26A4 variation and 92 infants with MT-RNR1 variation were at risk for enlarged vestibular aqueduct and aminoglycoside-induced ototoxicity respectively, indicating early aversive or preventive management. Conclusions and Relevance: This study found that performing modified genetic and hearing screening in newborns was feasible and provides evidence that the program could identify additional subgroups of infants who need early intervention. These findings suggest an advantage for universal adoption of such a practice.

Intra- and inter-observer agreements in detecting peri-implant bone defects between periapical radiography and cone beam computed tomography: A clinical study.

BACKGROUND/PURPOSE: Information regarding agreements between periapical radiograph (PA) and cone beam computed tomography (CBCT) in detecting peri-implant defect is still scarce. The aim of this clinical study was to compare agreements between PA and CBCT in detecting peri-implant bone defect. MATERIALS AND METHODS: This retrospective clinical study enrolled 32 patients with both PA and CBCT filmed right after implant placement. Four modalities were used for film reading: PA1 (original), PA2 (enhanced brightness/contrast), CBCT1 (selected axial and mesial-distal direction images) and CBCT2 (all data with software). 2 experienced and 2 inexperienced observers scored all films. Intra- and inter-observer agreements were estimated with Cohen's kappa coefficient. Categorized agreements were compared and differences among four modalities were calculated. RESULTS: Agreements of PA were better than CBCT when detecting peri-implant bone defects in inter-observer agreements (median kappa 0.471 vs. 0.192; p = 0.016). Moreover, agreements in experienced observers were better than inexperienced observers (median kappa 0.883 vs. 0.567; p < 0.001). There was significant difference among four modalities except for experienced observer 2 (p = 0.218). CONCLUSION: Agreements of PA are better than CBCT when detecting peri-implant bone defects, especially for inter-observer agreements. Experienced observers are more consistent in assessment than inexperienced ones.

[Expression of fibroblast growth factor receptor like 1 protein in oral squamous cell carcinoma and its influence on tumor cell proliferation and migration].

OBJECTIVE: This study aims to investigate the expression of fibroblast growth factor receptor like 1 (FGFRL1) in oral squamous cell carcinoma (OSCC) and reveals its association with tumor cell proliferation and migration. METHODS: Western blot was performed to detect the expression of FGFRL1 protein in OSCC tissues, adjacent normal tissues, OSCC cell lines and normal epithelial cells. After knocking down of FGFRL1 in HN4 cells, CCK-8 and Ki67 assays were performed to detect cell proliferation, wounding healing assay and transwell were performed to detect cell-migration. Western blot was used to detect the expression of protein related to epithelial-mesenchymal transition (EMT). RESULTS: The expression of FGFRL1 in OSCC tissues was higher than that in adjacent nontumor tissues, respectively (t=2.820, P=0.047 8). Moreover, the expression of FGFRL1 in OSCC cells was higher than that in HOK cells. Quantitative real-time polymerase chain reaction (qRT-PCR) showed that FGFRL1 expression of FGFRL1 RNA in HOK cells was lower than that in OSCC cells. HN4 cells transfected with FGFRL1 siRNA were included in the experimental group, whereas HN4 cells treated with NC siRNA were included in the control group. CCK-8 experiment showed no significant difference between the experimental and control groups with regard to proliferation ability at 48 h (P=0.478 1) and 72 h (P=0.334 2). Migration experiment showed that the wound healing areas in the experimental group after 12 h (P=0.022 8), 24 h (P=0.005 1), and 36 h (P=0.009 5）were smaller than that in the control group. Transwell invasion assay showed that the number of invaded cells in the experimental group after 16 h (P=0.008 7) and 24 h (P=0.008 6) were lower than that in the control group. Knocking-down FGFRL1 up-regulated the expression of E-cadherin and down-regulated the expression of N-cadherin and Vimentin in HN4 cells. CONCLUSIONS: FGFRL1 expression in the OSCC tissues was significantly higher than that in the adjacent nontumor tissues. FGFRL1 expression in the OSCC cells was significantly higher than that in the HOK cells, and FGFRL1 had no effect on cell proliferation but promoted tumor cell migration and EMT.

[Effect of bone grafting on the repair of distal alveolar bone defect of the second molar after extraction of mandibular impacted third molar].

PURPOSE: To observe the effect of bone grafting during the extraction of mandibular third molar on repair of distal alveolar bone defect distal to the second molar. METHODS: The risks of the distal alveolar bone defect in the second molar were estimated after removal of the impacted teeth according to the position of the third molar and second molar before operation. It was divided into three groups: low risk group, medium risk group and high risk group. The medium risk group and high risk group were further divided into bone graft subgroup (group A) and non-bone graft subgroup (group B). There were 36 cases in group A and 45 cases in group B. Postoperative re-examination indicators included subjective perception of the patients, depth of probing and height of alveolar bone in the distal molar of the second molar by X-ray examination. The data were analyzed with SPSS 19.0 software package. RESULTS: Six months after operation, in mediun risk group, 0 cases in group A had subjective feelings of cold and heat stimulation; in group B, the number was 6 cases, the difference was significant (P<0.05). Distal periodontal probing depth of the second molar was (2.93±0.34) mm in group A and (2.95±0.50) mm in group B. There was no significant difference between 2 groups (P=0.931). X-ray examination of the alveolar bone height increment of the second molar Δh: (3.31±1.02) mm in group A, (3.10±1.72) mm in group B, the difference was not significant (P=0.794). In high risk group, 4 cases in group A had subjective feelings of cold and heat stimulation; in group B, the number was 10 cases,the difference was significant (P<0.05). Distal periodontal probing depth of the second molar was (3.08±0.37) mm in group A and (3.24±0.41) mm in group B. There was no significant difference between 2 groups(P=0.931). X-ray examination of the alveolar bone height increment of the second molar Δh: (5.21±1.79) mm in group A, (2.99±2.42) mm in group B, the difference was significant (P<0.05). CONCLUSIONS: Risk classification of the second molar distal bone defects after extraction of the impacted teeth is essential, which is helpful to determine whether bone grafting is needed during operation. Autologous bone mixed with Bio-Oss artificial bone powder can promote recovery of the alveolar bone height of the second molar, especially in high risk group, and discomfort caused by exposure can be reduced.

[Study on the incentive strategy of "double guidance" way and "1+2" mode in the cultivation of master's degree postgraduates-A case study of Zhejiang Chinese Medical University].

With the degree of enrollment of postgraduates in medical specialty expanding year by year, medical colleges have been exposed the deficiencies in the education of professional degree, which is paying more attention to clinic but less to scientific research. Postgraduate students have weak scientific awareness and less enthusiasm. This study forward on reforming the teaching model and incentive strategy based on the questionnaire survey. The purpose was to encourage the professional degree postgraduate students to be involved in scientific research initiative, innovation ability, and improve the quality of postgraduate education.

[Application of panoramic film in predicting orthodontic treatment time for impacted maxillary canine].

PURPOSE: To evaluate the influence of pretreatment radiographic features (angle, distance, and location) on the duration of active orthodontic traction. METHODS: Sixty maxillary unilateral impacted canines were selected to analyze the panoramic features(angle, line spacing, and location) in pre-treatment patients， the results were evaluated using SPSS19.0 software package for multivariate regression analysis. RESULTS: Pretreatment radiographic variables (angle, line spacing, and location) were significantly associated with the duration of orthodontic traction. The sex and site of impaction did not significantly affect the duration of traction. CONCLUSIONS: Impacted canine angle, distance and position can predict the orthodontic traction time.

[Cone-beam CT evaluation of volume and surface area changes of impacted upper central incisors before and after orthodontic treatment].

PURPOSE: The purpose of this study was to quantitatively evaluate root resorption by cone-beam computer tomography (CBCT) after orthodontic treatment of impacted upper central incisors. METHODS: Ten patients (12 impacted incisors and 8 contralateral corresponding teeth) were included in this study. With self-designed modified nance arch and straight wire arch, the impacted incisors were treated by combined orthodontics and surgery approach. CBCT images of all patients were taken before and immediately after the treatment. Mimics software was used to build three-dimensional images. The upper central incisors were isolated. Volumes of teeth and superficial area were calculated. The difference between pre- and post- treatment was statistically evaluated with paired samples t test using SPSS13.0 software package. RESULTS: Significant difference in volume and superficial area was found between pre- and post- treatment (P<0.05). The average whole dental volume increase was (9.67±10.86) mm3, and the superficial area increase was (28.97±14.36)mm2. Statistical significance was achieved among 12 impacted incisors. The average whole dental volume increase of the control group was（12.38±10.22）mm3, and the superficial area increase was（30.64±16.74）mm2. There was no significant difference between the impacted and the control group in dental volume and superficial area before and after treatment (P>0.05). CONCLUSIONS: The treatment by combined orthodontics and surgery approach could promote tooth development for impacted incisors without causing root absorption, which can be safely performed.

[Clinical evaluation of simple maxillary sinus elevation with simultaneous implant in patients with serious posterior maxillary deficiency].

PURPOSE: To evaluate the clinical effect of simple osteotome sinus floor elevation without bone grafting in the posterior maxilla area with less bone height. METHODS: Twenty eight cases with posterior maxillary bone deficiency were included.Their residual alveolar bone height (RBH) was less than 7 mm. 40 ITI implants were implanted. Among them, 6 implants were implanted in the sites with RBH less than 4 mm (group 1), 34 were implanted in the sites with RBH between 4 to 7 mm (group 2).16 implants were inserted with bone graft, while 24 implants were inserted without bone graft. 6-12 months after operation, the alveolar bone height were measured and recorded. SPSS19.0 software package was used for data analysis. RESULTS: All 40 implants in 28 patients had good initial stability and good osseointegration, the success rate was 100%. RBH in group 1 and group 2 was (3.44±0.57) mm, (5.50±1.00) mm, respectively; postoperative bone increase was (7.91±1.06) mm in group 1, (8.77±1.15) mm in group 2, respectively (P>0.05).Preoperative RBHin bone graft group was (5.37±1.24) mm and (5.07±1.19) mm in patients without bone graft. Postoperative bone increase was (8.47±1.18) mm in bone graft group, and (8.89±1.13)mm in patients without bone graft, responsively (P>0.05). CONCLUSIONS: Maxillary sinus elevation can be successfully performed in patients with RBH<4 mm, and the effect is similar to that of conventional maxillary sinus lifting. Simple osteotome sinus floor elevation without bone grafting, which is with less trauma and lower cost, is effective in improving bone height in posterior maxillary region.

[Efficacy of bFGF atomization inhalation on postoperative sore throat following oral and maxillofacial surgery under general anesthesia].

PURPOSE: To observe the effect of recombinant human basic fibroblast growth factor (bFGF) atomization inhalation on postoperative sore throat following oral and maxillofacial operation under general anethesia. METHODS: Forty patients in whom oral and maxillofacial operation trachea was removed under general anesthesia were randomly divided into treatment and control groups; the treatment group received bFGF 35000IU + normal saline 20 mL, compression inhalation, day 1, every 20min, continued for 3 d; the control group was given normal saline 5 mL + dexamethasone 5 mg + gentamicin 80000 U + chymotrypsin 4000 U, compression inhalation, twice a day, every 20 min, continued for 3 d. Occurrence of postoperative sore throat 12 h after operation was recorded and visual analog scale (VAS) of sore throat (swallowing) 12,24,48,72 h after operation was measured. SPSS l4.0 software package was used for statistical analysis. RESULTS: The incidence of sore throat in the treatment group was significantly lower than that in the control group (P<0.01) 12 h after operation; sore throat (swallowing) VAS 12,24,48 and 72 h after operation in the treatment group were significantly lower than that in the control group (P<0.05). CONCLUSIONS: bFGF atomization inhalation can reduce the incidence of sore throat and sore throat level in oral and maxillofacial surgery after endotracheal intubation.

[Application of research-based learning for bachelor intern students of stomatology].

PURPOSE: To apply research-based learning in education of bachelor intern students of stomatology and evaluate its role in promoting the comprehensive quality of the students. METHODS: Sixty students from grade 2007 and 2008 in school of stomatology, Wenzhou Medical University were enrolled in this study. Thirty of them were randomly selected into a group for research-based learning, while the others were taught with traditional teaching mode. Survey and assessment of the teaching effect was performed after the course. Independent t test was employed to evaluate the differences with SPSS16.0 software package. RESULTS: No significant difference of exam results was revealed between the two groups. Questionnaire survey showed a good evaluation for the teaching mode and the teachers in the group research-based learning, but the evaluation of mastering research capability was lower. CONCLUSIONS: Research-based learning mode promotes the study interest and comprehensive quality of the students. No evidence of interference with mastering clinical skills is disclosed.

Multiple idiopathic cervical root resorptions: report of one case with 8 teeth involved successively.

Multiple idiopathic cervical root resorptions is a rare condition which is usually detected as an incidental radiographic finding. It involves more than 3 teeth in the same patient and the etiology remains elusive. Diagnosis and treatment of the defect is still challenging. The present report describes a case with progressive multiple external cervical resorption involving 8 teeth, including the history, clinical and radiographic findings. Treatment included surgical intervention and restoration of the defect. A 3-month reevaluation of the case confirmed a stable, uneventful clinical recovery.

Guidelines for the treatment of head and neck venous malformations.

Venous malformation is one of the most common benign vascular lesions, with approximately 40% of cases appearing in the head and neck. They can affect a patient's appearance and functionality and even cause life-threatening bleeding or respiratory tract obstruction. The current methods of treatment include surgery, laser therapy, sclerotherapy, or a combined. The treatment of small and superficial venous malformations is relatively simple and effective; however, the treatment of deep and extensive lesions involving multiple anatomical sites remains a challenge for the physicians. For complex cases, the outcomes achieved with one single treatment approach are poor; therefore, individualized treatment modalities must be formulated based on the patient's condition and the techniques available. Comprehensive multidisciplinary treatments have been adapted to achieve the most effective results. In this paper, based on the national and international literature, we formulated the treatment guidelines for head and neck venous malformations to standardize clinical practice. The guideline will be renewed and updated in a timely manner to reflect cutting-edge knowledge and to provide the best treatment modalities for patients.

[Xeroderma pigmentosum with repeated facial skin carcinogenesis: report of one case].

Xeroderma pigmentosum is a relatively rare pigment atrophic autosomal recessive genetic disease, mainly due to defect of DNA excision repair capacity, resulting in ineffective removal of UV-induced pyrimidine dimers, and finally cell damage. This paper reported a case of xeroderma pigmentosum with recurrent episodes of oral and maxillofacial carcinogenesis, and discussed the etiology, pathology, clinical characteristics, classification, diagnosis and treatment methods of Xeroderma pigmentosum.

[Mandibular condyle ectomy for the treatment of comminuted condylar fracture].

PURPOSE: To investigate the feasibility and indication of condylectomy for treatment of comminuted fractures of the condyle above the neck. METHODS: Sixty-one patients with condylar fractures, treated between September 2007 and September 2011 were reviewed respectively. Among them, 30 underwent open reduction and internal fixation, 15 underwent conservative therapy, and 16 patients (18 sides) who had comminuted fractures of the condyle above the neck underwent condylectomy. All the patients were followed up for 5 to 48 months after treatment to evaluate the outcomes. RESULTS: Among the 16 patients with condylectomy, poor wound healing due to rejection of hemostatic gauze was noted in 1 patient, occlusal deviation occurred in 1 patient, mild mouth opening limitation happened in 1 patient, and anterior open bite was present in 1 patient. The other patients recovered well, without apparent discomfort, malocclusion and facial asymmetry. CONCLUSIONS: For patients with finished maxillofacial growth, condylectomy is a feasible and effective way for management of comminuted fractures of the condyle above the neck. Postoperative occlusal deviation, open bite and limited mouth opening can be corrected with further expectant treatment.

[Treatment of infantile hemangiomas with long pulsed 1064nm laser and oral corticosteroids].

PURPOSE: To evaluate the clinical therapeutic efficacy on infantile hemangiomas using long pulsed 1064nm laser and oral corticosteroid. METHODS: One hundred and two infantile hemangiomas in the proliferating phase state were treated with long pulsed 1064nm laser, long pulsed 1064nm laser and oral corticosteroid .Color Doppler was used to detect the depth of tumor. Laser treatment was conducted for 1 to 3 sessions, and oral corticosteroid was one course for 12 weeks. The results were analyzed with SAS6.12 software package for Ridit test. RESULTS: Total response treated with long pulsed 1064nm laser, long pulsed 1064nm laser and oral corticosteroid were achieved in 12 cases(24.00%) and 14 cases(26.92%)respectively, good response were achieved in 18 cases(36.00%) and 27 cases(51.92%). There was significant difference between the two groups(P<0.05). Total response in patients with superficial lesions treated with long pulsed 1064nm laser, long pulsed 1064nm laser and oral corticosteroid were achieved in 8 cases(34.78%) and 7 cases(33.33%) respectively, while good response were achieved in 10 cases(43.48%) and 8 cases(38.10%).There was no significant difference between two groups(P>0.05).Total response in patients with deep lesions treated with long pulsed 1064nm laser, long pulsed 1064nm laser and oral corticosteroid were achieved in 4 cases(14.81%) and 7 cases(22.58%) respectively, good response were achieved in 8 cases(29.63%) and 19 cases(61.29%).There was significant difference between the two groups(P<0.05). CONCLUSION: Combined therapy with long pulsed 1064nm laser and oral corticosteroid is effective for infantile deep-seated hemangiomas in the proliferating stage.