Repair of buccal mucosa and floor of mouth defects using keystone design perforator island flap.

OBJECTIVE: To assess the feasibility of utilizing the keystone design perforator island flap (KDPIF) for the repair of small to medium-sized defects in the buccal mucosa and floor of mouth (cT1-2 stage tumor). STUDY DESIGN: We conducted a retrospective analysis of eight patients who underwent KDPIF to address oral defects at the Affiliated Hospital of Qingdao University between June 2021 and September 2022. Patient information, including medical history, defect site, flap size, operative time, hospital stay, complications, and postoperative recovery of oral function, was comprehensively evaluated. RESULTS: Eight patients (6 females and 2 males) underwent reconstruction using KDPIF. The mean operation time was 58.5 minutes (55-63 minutes), with an average length of stay of 3.5 days (3-5 days). None of the 8 cases (100%) exhibited flap splitting necrosis or infection. Moreover, no scar contracture was observed, and oral functions, including the degree of opening, type of opening, tongue mobility, speech function, and swallowing function, were successfully restored. One patient (12.5%) experienced bleeding from the incision on the first postoperative day, but following compression, hemostasis was achieved, and the incision healed well. CONCLUSIONS: KDPIF demonstrates technical feasibility and suitability for repairing small to medium-sized buccal mucosa and floor of mouth defects (cT1-2).

Dietary nitrate accelerates the healing of infected skin wounds in mice by increasing microvascular density.

As skin injuries resulting from acute trauma, burns, and chronic diseases present significant challenges to healthcare systems worldwide, the promotion of skin wound healing remains an unmet therapeutic area. Dietary nitrate serves as a crucial pathway for the production of nitric oxide, which plays various physiological roles in the body, including vasodilation, increased blood flow, and antioxidant activity. However, the impact of dietary nitrate on skin wound healing remains uncertain. This study aimed to investigate the role of dietary nitrate in infected skin wound healing using a mouse model. We created a full-thickness wound infection model in mice and examine the effects of dietary nitrate (0.5 mmol/kg/d and 1 mmol/kg/d) on wound healing. The results demonstrated that dietary nitrate significantly increased serum nitrate and nitrite levels, leading to accelerated wound healing by increasing microvascular density, promoting collagen deposition and re-epithelialization. Moreover, nitrate supplementation exhibited a certain degree of reduction in inflammatory factors within the body. Our study also found that 1 mmol/kg/d nitrate has a more effective therapeutic effect and can increase blood perfusion and expedite the formation of new blood vessels, thereby promoting skin wound healing. These results indicate that dietary nitrate presents a novel therapeutic approach for infected skin wound healing.

Comprehensive Management of a Giant Venous Malformation of the Lip: Vascular Embolization Followed by Surgical Resection and Reconstruction.

Venous malformations often manifest in early childhood and do not spontaneously resolve. Most vein malformations of the lips are typically treated at a young age, with giant arteriovenous malformations being particularly rare. Herein, we introduce the case of a 47-year-old man who presented to our department complaining of a progressive mass on his lower lip. Clinical examination revealed a mass measuring 10 cm × 8 cm × 4 cm in size, characterized by a soft texture and smooth edges. Despite a series of sclerotherapy interventions, the lesion remained unresponsive. Consequently, we performed a preoperative embolization of the malformed vessel using digital angiography, followed by extensive resection of the lesion and repair of the defect using an adjacent flap. The postoperative period was uneventful, and no local recurrence was observed during a 4-year follow-up period. Therefore, we recommend preoperative angioembolization as a valuable approach for addressing large lower lip deformities to enable extensive surgical resection and robust therapeutic outcomes.

Diffuse Large B-cell Lymphoma (Leg Type) Originating in the Skin of the Right Cheek Region: A Case Report and Literature Review.

Primary diffuse cutaneous large B-cell lymphoma, leg type (PCDLBCL-LT), usually affecting one or both lower legs, with a 5-year disease-free survival rate of less than 60%. Solitary facial lesions are extremely rare. Our report is about a 93-year-old woman whose clinical examination revealed a 4 cm × 5 cm × 3 cm mass with a soft texture and smooth margins on the right side of her cheek. Immunohistochemical analyses were consistent with a diagnosis of PCDLBCL-LT. The surgical method for this patient was: extensive resection of the tumor and repair of the defect with an adjacent flap. Neither local recurrence nor systemic invasion was observed during postoperative follow-up (8 months). The clinician must be very careful when making a correct diagnosis based on the clinical and immunohistochemical findings of PCDLBCL-LT. For this type of PCDLBCL-LT isolated in 1 site without invasion of the rest of the body, extensive surgical resection may result in a favorable prognosis.

Pyogenic granuloma of the gums and lips caused by camrelizumab: case report and literature review / 口腔疾病防治

Objective@# To investigate the clinical manifestations, pathological features, and treatment of oral and maxillofacial pyogenic granulomas induced by camrelizumab. @*Methods@# A case of pyogenic granuloma of the gums and lips caused by camrelizumab was reported along with a literature review. @*Results@# After 4 months of treatment with camrelizumab for liver cancer, the patient developed systemic reactive capillary hyperplasia (RCH), followed by multiple masses on the lower lip and gingiva. After periodontal therapy, the masses on the lower lip and the gingiva were removed, and camrelizumab administration was stopped. The pathological result was gingival pyogenic granuloma/granulomatous hemangioma. No new masses were found in the oral cavity during postoperative follow-up. A review of the literature showed that RCH is the most common adverse drug reaction to camrelizumab but it occurs infrequently in the oral cavity. At present, the etiology of RCH has not been clarified, but the research has shown that camrelizumab may trigger tissue proliferation into hemangiomas by activating vascular endothelial cells, and the combined use of camrelizumab is safer than single use. RCH is self-limiting and most cases resolve spontaneously after discontinuation of the drug. If the mass causes dysfunction, surgical excision is feasible.@*Conclusion @#Camrelizumab can cause oral and maxillofacial reactive capillary hyperplasia complicated by pyogenic granuloma.

Drainage and Orbitofrontal Reconstruction After Removal of a Giant Frontal Sinus Osteoma: A Case Report.

After removal of a large frontal sinus osteoma in this case, the contralateral nasofrontal canal was opened to drain the intraoperative fluid and prevent infection, and the defect in the orbitofrontal area was restored using a titanium mesh designed with 3D printing technology.

Semaphorin 3A attenuates the hypoxia suppression of osteogenesis in periodontal ligament stem cells.

OBJECTIVE AND BACKGROUND: The occurrence and development of periodontitis are closely related to hypoxia of the periodontal microenvironment. Periodontal ligament stem cells (PDLSCs) are considered to have potential to regenerate periodontal tissues. Semaphorin 3A (Sema3A) plays an essential role in promoting osteogenesis. However, the effect of Sema3A on osteogenesis of PDLSCs under hypoxia remains unclear. The aim of this study was to investigate the effect of Sema3A on osteogenesis of PDLSCs under hypoxia. METHODS: Isolated PDLSCs were identified using flow cytometry. Adipogenic differentiation potential was identified by oil red O staining. Osteogenesis was measured using Alizarin Red S staining and ALP staining. Intracellular hypoxia was induced using cobalt chloride (CoCl2 ). The expression level of hypoxia-inducible factor-1α (HIF-1α) was detected via ELISA. Expression of osteogenic markers and Sema3A was analyzed using western blot and real-time PCR. RESULTS: The proliferation and osteogenesis of PDLSCs were markedly inhibited with increased concentrations of CoCl2 . Under the treatment with a low concentration of CoCl2 , expression of related osteogenic markers and Sema3A decreased in a time-dependent manner. ARS and ALP staining results also showed that osteogenic calcification decreased under hypoxia. Apigenin, an inhibitor of HIF-1α, effectively up-regulated expression of Sema3A and osteogenic markers with CoCl2 treatment. Moreover, exogenous Sema3A significantly increased the expression of osteogenesis-related markers and mineralization of PDLSCs according to ALP and ARS staining with CoCl2 treatment. CONCLUSIONS: Hypoxia markedly inhibited osteogenesis of PDLSCs. Sema3A explicitly attenuated the hypoxia suppression of osteogenesis in PDLSCs.

Identification of a six-gene prognostic signature for oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is one of the most common types of malignancies worldwide, and its morbidity and mortality have increased in the near term. Consequently, the purpose of the present study was to identify the notable differentially expressed genes (DEGs) involved in their pathogenesis to obtain new biomarkers or potential therapeutic targets for OSCC. The gene expression profiles of the microarray datasets GSE85195, GSE23558, and GSE10121 were obtained from the Gene Expression Omnibus (GEO) database. After screening the DEGs in each GEO dataset, 249 DEGs in OSCC tissues were obtained. Kyoto Encyclopedia of Genes and Genomes and Gene Ontology pathway enrichment analysis was employed to explore the biological functions and pathways of the above DEGs. A protein-protein interaction network was constructed to obtain a central gene. The corresponding total survival information was analyzed in patients with oral cancer from The Cancer Genome Atlas (TCGA). A total of six candidate genes (CXCL10, OAS2, IFIT1, CCL5, LRRK2, and PLAUR) closely related to the survival rate of patients with oral cancer were identified, and expression verification and overall survival analysis of six genes were performed based on TCGA database. Time-dependent receiver operating characteristic curve analysis yields predictive accuracy of the patient's overall survival. At the same time, the six genes were further verified by quantitative real-time polymerase chain reaction using samples obtained from the patients recruited to the present study. In conclusion, the present study identified the prognostic signature of six genes in OSCC for the first time via comprehensive bioinformatics analysis, which could become potential prognostic markers for OCSS and may provide potential therapeutic targets for tumors.

[Intramuscular type of nodular fasciitis: a report of 3 cases and review of literature].

PURPOSE: To retrospectively analyze the clinical characteristics of impacted supernumerary teeth in 115 patients. METHODS: One hundred and fifteen patients with im-pacted supernumerary teeth who were admitted to the Department of Oral and Max-illofacial Surgery of Hefei Stomatological Hospital were selected randomly. The age, sex, number of teeth, location, direction, clinical manifestation, anaes-thesia method and operation time were analyzed retrospectively, T test and Chi-square test were used to determine the statistical differences with SPSS 19.0 software package. RESULTS: Among 115 patients, there were 176 impacted supernu-merary, most of them were in mixed dentition period (66.96%), the sex ratio was 2.29:1, and Most patients (59.1%) had one supernumerary tooth, followed by two supernumerary teeth(33.9%). Most supernumerary teeth were located in the middle of the maxilla (68.2%). Inverted ones were the most common (52.8%). The most common symptoms were delayed eruption, displacement, crowding, torsion and space of the adjacent teeth. 92.2% of patients underwent general anesthesia. The dee-per the locations of impacted supernumerary were, the longer the operation time was. CONCLUSIONS: There are regional characteristics of supernumerary teeth in Hefei City, which can provide a reference for clinical diagnosis and treatment.

Dietary nitrate protects skin flap against ischemia injury in rats via enhancing blood perfusion.

Insufficient blood supply is associated with high levels of necrosis in reconstructive surgery. Restoring blood flow to undersupplied ischemic tissue is the most important impact factor determining skin flap viability. Dietary nitrate, a significant source of nitric oxide, has multiple physiological functions, including regulator of blood flow, angiogenesis, and vasodilatation. However, the effects of dietary nitrate on ischemic skin flap remain unknown. The present study evaluated whether dietary nitrate supplementation altered blood flow of ischemic skin flap in rats. Our results showed that nitrate treatment significantly enhanced ischemic tissue survival. Mechanistically, nitrate therapy significantly increased serum nitrate and nitrite levels, blood perfusion, and angiogenesis. In addition, the circulating levels of Inflammatory mediators were decreased by nitrate supplementation. In conclusion, we demonstrated that dietary nitrate supplementation protected ischemic skin flap by enhancing ischemia-induced revascularization.

Dietary Nitrate Protects Against Skin Flap Ischemia-Reperfusion Injury in Rats via Modulation of Antioxidative Action and Reduction of Inflammatory Responses.

Dietary nitrate, found abundant in green vegetables, can be absorbed into the blood and be converted to nitric oxide (NO) in the body. Dietary nitrate has been proved to have many positive physiological functions in the body. Here, we evaluated the therapeutic effects of dietary nitrate on skin flap recovery following ischemia reperfusion (IR). Wistar rats were pretreated with nitrate from one week prior to ischemia to the end of reperfusion. It was found that oral administration of nitrate increased serum nitrate and nitrite levels, protected cells from apoptosis, and attenuated flap tissue edema. In the meantime, the oxidative stress marker malondialdehyde was reduced, while the activities of antioxidant enzymes were restored after nitrate treatment. Moreover, the macrophage and neutrophil infiltration in the flap was significantly attenuated by nitrate supplementation, as were the pro-inflammatory cytokines. In sum, we found that oral administration of nitrate can attenuate skin flap IR injury through the regulation of oxidative stress and inflammatory response.

[Pigmented villonodular synovitis of the temporomandibular joint：report of one case and review of literatures].

Pigmented villonodular synovitis (PVNS) is a benign， proliferative disorder of synovium. It often affects the knee, and rarely occurs in the temporomandibular joint (TMJ). This paper reported a 45-year-old male patient with PVNS of the TMJ, who was referred with a chief complaint of slowly growing and painless preauricular mass that was noticed about 1 year. Radical excision and follow-up were conducted, no recurrence and metastasis were noted.

[Synovial chondromatosis in the temporomandibular joint: report of 2 cases].

The clinical manifestations, radiographic findings, intraoperative view, histopathologic features of synovial chondromatosis（SC） in the temporomandibular joint (TMJ) were summarized in 2 cases. Preoperative symptoms included preauricular pain（2/2）, swelling（2/2） and limitation of mouth opening (0/2). X-ray findings showed widened joint space. The articular surface destructed and irregular stippled calcifications were seen in the infratemporal fossa by CT scan in one case. MRI showed multiple small nodular formations in the articular cavity. There was no malocclusion and limitation of mouth opening after surgery. As a rare disease of the temporomandibular joint， SC often exists in superior spaces. The clinical manifestations lack specificity. Detection of calcified loose bodies on radiography was helpful to diagnosis, while final diagnosis was dependent on histopathologic examination with characteristic cartilaginous nodules in the synovial membrane.

Novel evidence of association with nonsyndromic cleft lip with or without cleft palate was shown for single nucleotide polymorphisms in FOXF2 gene in an Asian population.

BACKGROUND: The forkhead box F2 gene (FOXF2) located in chromosome 6p25.3 has been shown to play a crucial role in palatal development in mouse and rat models. To date, no evidence of linkage or association has been reported for this gene in humans with oral clefts. METHODS: Allelic transmission disequilibrium tests were used to robustly assess evidence of linkage and association with nonsyndromic cleft lip with or without cleft palate for nine single nucleotide polymorphisms (SNPs) in and around FOXF2 in both Asian and European trios using PLINK. RESULTS: Statistically significant evidence of linkage and association was shown for two SNPs (rs1711968 and rs732835) in 216 Asian trios where the empiric P values with permutation tests were 0.0016 and 0.005, respectively. The corresponding estimated odds ratios for carrying the minor allele at these SNPs were 2.05 (95% confidence interval = 1.41, 2.98) and 1.77 (95% confidence interval = 1.26, 2.49), respectively. CONCLUSION: Our results provided statistical evidence of linkage and association between FOXF2 and nonsyndromic cleft lip with or without cleft palate.

Gene mutations in the D-loop region of mitochondrial DNA in oral squamous cell carcinoma.

The present study aimed to investigate gene mutations in the displacement­loop (D­loop) region of mitochondrial DNA (mtDNA) in patients with oral squamous cell carcinoma (OSCC) in order to examine the role of gene mutation in mtDNA in OSCC tumorigenesis. mtDNA was obtained from cancer tissues, paracancerous tissues and normal mucosal tissues of thirty patients with OSCC. The D­loop region of the mtDNA was amplified using polymerase chain reaction, sequenced and then analyzed by Chromas software and BLAST to identify the mutation sites. Mutations in the D­loop region were observed in the cancer tissue samples of eight out of thirty cases with OSCC, with a mutation rate of 27%. There were nine mutations in total, including one point mutation, two base deletions, three insertion mutations and three heterozygous mutations. In these mutations, base deletions were different from each other and heterozygous mutations did not have the same mutation form; however, the three insertion mutations were the same, consisting of an insertion of a C base. One case contained a T/A heterozygous mutation as well as base insertion of C. The eight cases with mutations in the D­loop region consisted of three cases of tongue cancer, two cases of soft palate cancer, one case of floor of the mouth cancer, one case of oropharyngeal cancer and one case of lip cancer. This study demonstrated mutations in the mtDNA D­loop region in OSCC cells; however, the association between occurrences of OSCC and mtDNA mutations requires further investigation.

[Soft-tissue osteomas in buccal space: a case report and review of the literatures].

Osteoma is a benign tumor, which is composed of mature differentiated bone tissue .Osteoma can be central, peripheral or extraskeletal. Extraskeletal osteoma also is called soft-tissue osteoma. Extraskeletal soft-tissue osteoma is exceedingly rare, especially in the oral cavity. This article reported a case with soft-tissue osteomas in buccal space. The histogenesis, differential diagnosis, pathologic type and treatment were discussed. Surgical resection is suggested as the main treatment for this disease.

Construction of functional tissue-engineered bone using cell sheet technology in a canine model.

The aim of the present study was to construct functional tissue-engineered bone with cell sheet technology and compare the efficacy of this method with that of traditional bone tissue engineering techniques. Canine bone mesenchymal stem cells (BMSCs) were isolated using density gradient centrifugation and then cultured. The BMSCs were induced to differentiate into osteoblasts and cultured in temperature-responsive culture dishes. The BMSCs detached automatically from the temperature-responsive culture dishes when the temperature was reduced to 20°C, forming an intact cell sheet. Demineralized bone matrix (DBM) and platelet-rich plasma (PRP) were prepared and used to construct a DBM/PRP/BMSC cell sheet/BMSC complex, which was implanted under the left latissimus dorsi muscle in a dog model. A DBM/PRP/BMSC complex was used as a control and implanted under the right latissimus dorsi muscle in the dog model. Immunoblot assays were performed to detect the levels of growth factors. Osteogenesis was observed to be induced significantly more effectively in the DBM/PRP/BMSC cell sheet/BMSC implants than in the DBM/PRP/BMSC implants. Immunoblot assay results indicated that the levels of the growth factors platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) in the experimental group were 3.2- and 2.5-fold higher compared with those in the control group, respectively. These results indicated that the BMSC cell sheets were functional and more effective than the control cell complex. Therefore, cell sheet technology may be used for the effective construction of functional tissue-engineered bone with ideal properties.

[The effect evaluation of suction drainage to prevent fistula after superficial parotidectomy].

PURPOSE: To evaluate the clinical value of suction drainage to prevent fistula after parotidectomy, and seek the best opportunity to remove the drainage according to the draining output and duration. METHODS: One hundred and ninety-four patients with parotid diseases after superficial parotidectomy were assigned into pressure dressing group and suction drainage group. Pressure dressing was used after suction drainage tube was removed in the pressure group, while suction drainage tube was fixed through the process in the suction group. Postoperative salivary fistula occurrence between the 2 groups was analyzed with Pearson chi-square test, and the contribution of the output and duration resulting in salivary fistula was analyzed by Fisher's exact test with SPSS 19.0 software package. RESULTS: The occurrence of salivary fistula in the pressure dressing group and suction group was 11.6% and 15.5%, respectively in the suction group. No significance difference was found between the 2 groups (P>0.05). In the suction drainage group, significant correlation of the draining duration and salivary fistula was not found (P>0.05). However, the draining output less than 20 mL resulted in lower salivary fistula rate compared with the draining output of 20-30 mL. CONCLUSIONS: According to our findings, suction drainage can be used as a substitute for pressure dressing after parotidectomy in preventing salivary fistula, and the best timing of drainage extubation is when the draining output is less than 20 mL within 24 hours.

[Screening of the gene mutation in D-loop region of mitochondrial DNA in oral squamous cell carcinoma].

OBJECTIVE: To investigate the gene mutation in D-loop region of mitochondrial DNA (mtDNA) in oral squamous cell carcinoma (OSCC) tissue and to explore the role of the gene mutation in D-loop region in the OSCC tumorigenesis. METHODS: mtDNA was obtained from cancer, paracancerous and normal mucosa tissues of thirty patients with OSCC. The D-loop regions of mtDNA were amplified with PCR, sequencing and then analyzed by Chromas software and BLAST to identify the mutation site. RESULTS: Mutation in the D-loop region was found in eight cases, with the mutation rate of 27%. There were nine mutations totally, including one point mutation, two base deletions, three insertion mutations, three heterozygous mutations. In these mutations, base deletions were different from each other and heterozygous mutations had no same mutation form, while the three insertion mutations were same, the insertion of base C. One case had T/A heterozygous mutation and base C insertion at the same time. CONCLUSIONS: There were mutations in mtDNA D-loop in OSCC, but the relationship between occurrence of OSCC and mutation of mtDNA needs further study.