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Table of Content
01 June 2015, Volume 33 Issue 3
  • Modern concepts of trauma care and multiple trauma management in oral and maxillofacial region
    Tan Yinghui
    West China Journal of Stomatology. 2015, 33(3):  221-225.  doi:10.7518/hxkq.2015.03.001
    Abstract ( 773 )   HTML ( 9 )   PDF(pc) (895KB) ( 646 )   Save
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    Multiple trauma management requires the application of modern trauma care theories. Optimal treatment results can be achieved by reinforcing cooperation and stipulating a treatment plan together with other disciplines. Based on modern theories in trauma care and our understanding of the theoretical points, this paper analyzes the injury assessment strategies and methods in oral and maxillofacial multiple trauma management. Moreover, this paper discusses operating time and other influencing factors as well as proposed definitive surgical timing and indications in comprehensive management of oral and maxillofacial multiple trauma patients associated with injuries in other body parts. We hope that this paper can help stomatological physicians deepen their understanding of modern trauma care theories and improve their capacity and results in the treatment of oral and maxillofacial multiple trauma.

    The study of the colorimetric characteristics of the cobalt-chrome alloys abutments covered by four different all-ceramic crowns by using dental spectrophotometer
    Chen Yifan, Liu Hongchun, Meng Yukun, Chao Yonglie, Liu Changhong.
    West China Journal of Stomatology. 2015, 33(3):  226-229. 
    Abstract ( 875 )   HTML ( 10 )   PDF(pc) (1022KB) ( 841 )   Save
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    Objective  This study aims to evaluate the optical data of the different sites of the cobalt-chrome (Co-Cr) alloy abutments covered by four different all-ceramic crowns and the color difference between the crowns and target tab using a digital dental spectrophotometer. Methods  Ten Co-Cr alloy abutments were made and tried in four different groups of allceramic crowns, namely, Procera aluminia, Procera zirconia, Lava zirconia (Lava-Zir), and IPS E.max glass-ceramic lithium disilicate-reinforced monolithic. The color data of the cervical, body, and incisal sites of the samples were recorded and analyzed by dental spectrophotometer. The CIE L*, a*, b* values were again measured after veneering. The color difference between the abutments covered by all-ceramic crowns and A2 dentine shade tab was evaluated. Results  The L* and b* values of the abutments can be increased by all of the four groups of all-ceramic copings, but a* values were decreased in most groups. A statistical difference was observed among four groups. After being veneered, the L* values of all the copings declined slightly, and the values of a*, b* increased significantly. When compared with A2 dentine shade tab, the ΔΕ of the crowns was below 4. Conclusion  Four ceramic copings were demonstrated to promote the lightness and hue of the alloy abutments effectively. Though the colorimetric baseline of these copings was uneven, veneer porcelain can efficiently decrease the color difference between the samples and thee target.

    Comparison of magnetic resonance imaging artifacts of five common dental materials
    Xu Yisheng, Yu Risheng.
    West China Journal of Stomatology. 2015, 33(3):  230-233.  doi:10.7518/hxkq.2015.03.003
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    Objective  To compare five materials commonly used in dentistry, including three types of metals and two types of ceramics, by using different sequences of three magnetic resonance imaging (MRI) field strengths (0.35, 1.5, and 3.0 T). Methods  Three types of metals and two types of ceramics that were fabricated into the same size and thickness as an incisor crown were placed in a plastic tank filled with saline. The crowns were scanned using an magnetic resonance (MR) machine at 0.35, 1.5, and 3.0 T field strengths. The T1WI and T2WI images were obtained. The differences of various materials in different artifacts of field MR scans were determined. Results  The zirconia crown presented no significant artifacts when scanned under the three types of MRI field strengths. The artifacts of casting ceramic were minimal. All dental precious metal alloys, nickel-chromium alloy dental porcelain, and cobalt-chromium ceramic alloy showed varying degrees of artifacts under the three MRI field strengths. Conclusion  Zirconia and casting ceramics present almost no or faint artifacts. By contrast, precious metal alloys, nickel-chromium alloy dental porcelain and cobalt-chromium ceramic alloy display MRI artifacts. The artifact area increase with increasing magnetic field.

    Experimental study on the effects of the nerve growth factor regulating calcitonin gene-related peptide in promoting the proliferation of MG-63 in vitro
    Sun Song, Gao Qiangguo, Zhang Gang, Tan Yinghui.
    West China Journal of Stomatology. 2015, 33(3):  234-237.  doi:10.7518/hxkq.2015.03.004
    Abstract ( 767 )   HTML ( 3 )   PDF(pc) (1626KB) ( 701 )   Save
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    Objective  To investigate the nerve growth factor (NGF) regulating the expression of calcitonin gene-related peptide (CGRP) in promoting the proliferation of osteoblast-like cell (MG-63) and thus illustrate the mechanism of the NGF in wound healing. Methods  Different concentrations of NGF were used to stimulate MG-63. The expression of CGRP was detected by real-time quantitative polymerase chain reaction (RT-QPCR) and enzyme-linked immunosorbent assay after 1, 2, 3, and 4 days. The proliferation of MG-63 was detected by cell counting kit-8 (CCK-8). The expression of CGRP mRNA and the proliferation of MG-63 were then detected by RT-QPCR and CCK-8 after adding the NGF receptor blocker. Results  Compared with the blank control group, the expression of CGRP significantly increased by stimulating the NGF. The expression of CGRP was positively related to the concentration of NGF (P<0.05). Moreover, the expression of CGRP increased by prolonging the NGF stimulation time. The proliferation of MG-63 increased after stimulating the NGF (P<0.05). After adding the NGF receptor blocker, the expression of CGRP and the proliferation of MG-63 correspondingly decreased (P<0.05). Conclusion  NGF can up-regulate the expression of CGRP and increase the proliferation of MG-63. Therefore, NGF plays a significant role in wound healing.

    Culturing and characterization of human gingival mesenchymal stem cells and their chemotactic responses to stromal cell-derived factor-1
    Du Lingqian, Yang Pishan, Ge Shaohua.
    West China Journal of Stomatology. 2015, 33(3):  238-243.  doi:10.7518/hxkq.2015.03.005
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    Objective  To investigate the expression of chemokine stromal cell-derived factor-1 (SDF-1) receptor CXCR4 in human gingival mesenchymal stem cells (GMSCs) and the migration potential of GMSCs stimulated with SDF-1. Methods  Human GMSCs were isolated by single-cell cloning method. Their cell surface markers were characterized by flow cytometry, and the rate of colony formation was evaluated. Differentiation assay was used to detect the differentiation potential of GMSCs. The expression of chemokine SDF-1 receptor CXCR4 in GMSCs was detected by immunocytochemical staining. The chemotactic effect of SDF-1 on GMSCs was detected using a 24-multiwell Transwell cell culture chamber. The number of net migrated cells was counted in different microscope fields. Results  Human GMSCs possessed high self-renewal potential and formed single-cell colonies cultured in vitro. GMSCs expressed mesenchymal stem cells-associated markers CD44, CD73, CD90, CD105, and CD166, and the expression of hemopoietic stem cell surface markers CD14, CD34, and CD45 was negative. GMSCs differentiated into osteoblasts and adipocytes under defined culture conditions. The colony forming unit-fibroblastic for GMSCs was 21.4%±2.8%. Immunocytochemical staining demonstrated that GMSCs expressed chemokine SDF-1 receptor CXCR4. The number of GMSCs migrating at concentrations of 100 ng·mL-1 and 200 ng·mL-1 of SDF-1 in the Transwell cell culture chamber was significantly higher than that of the negative control (189.3±4.4, 164.6±4.9 cells/field vs. 47.8±2.5 cells/field, P<0.01). Treatment with the CXCR4 neutralizing antibody, an antagonist for CXCR4, significantly reduced the migratory effect compared with the negative controls (29.0±2.4 cells/field vs. 47.8±2.5 cells/field, P<0.01). Conclusion  Human GMSCs express chemokine SDF-1 receptor CXCR4. SDF-1 may participate in regulating chemotaxis of human GMSCs. Results suggest that the migration induced by SDF-1 is mediated by CXCR4.

    Immunoexpression and clinical significance of interleukin-21 and receptor activator of nuclear factor κB ligand in human periapical granulomas and radicular cysts
    Hu Juhua, Li Qian, Wang Yanqing, Li Song.
    West China Journal of Stomatology. 2015, 33(3):  244-248.  doi:10.7518/hxkq.2015.03.006
    Abstract ( 680 )   HTML ( 3 )   PDF(pc) (964KB) ( 618 )   Save
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    Objective  This study aimed to detect the immunoexpression of interleukin-21 (IL-21) and receptor activator of nuclear factor κB ligand (RANKL) in periapical granulomas (PGs) and radicular cysts (RCs). The interaction of IL-21 with RANKL and its role in periapical pathogenesis were also speculated. Methods  A total of 32 PGs and 23 RCs were selected as experimental samples. Lesion size and occurrence of tenderness were recorded. Up to 10 healthy gingival tissues were collected as normal control samples. All tissues were subjected to immunohistochemical analysis with anti-human IL-21 and RANKL polyclonal antibodies. The correlations of IL-21 with RANKL, lesion size, and the occurrence of tenderness of the PGs and RCs were evaluated. Results  IL-21-positive cells were detected in all periapical lesion tissues but not in normal tissues. In the cyst group and granuloma group, the corresponding expression levels of IL-21 were 59.92±6.57 and 36.80±6.81, whereas those of RANKL were 68.81±18.59 and 36.12±14.87, respectively. Moreover, t-test revealed a significantly higher expression of IL-21 and RANKL in RCs than in PGs (P<0.05). IL-21 and RANKL were positively correlated in both PGs and RCs (P<0.05). Furthermore, IL-21 was correlated with lesion size (P<0.05). Conclusion  This study demonstrated that IL-21 is potentially involved in the pathogenesis of apical periodontitis lesions. A role in the exacerbation of chronic inflammation, as well as in bone resorption, is suspected. Further studies are required to elucidate the specific functions of IL-21 in periradicular inflammatory processes.

    Interleukin-23 strengthens the anti-apoptotic and drug resistance of human tongue squamous cell carcinoma through the Wingless-related integration site/β-catenin pathway
    Yan Qin, Su Yuting, Zhou Yuepeng, Zhu Haitao, Yang Xihu, Xu Jianhui.
    West China Journal of Stomatology. 2015, 33(3):  249-254.  doi:10.7518/hxkq.2015.03.007
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    Objective  This study aims to detect the expression level of interleukin-23 (IL-23) in tongue squamous cell carcinoma tissues and its relationship with clinical prognosis, as well as explore the anti-apoptotic and drug resistance of the tongue squamous cell line-SCC9 before and after treatment with IL-23. Methods  The expression of IL-23 in tumor tissues from 28 tongue cancer patients was analyzed by immunohistochemistry assay. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the mRNA expression of Wingless-related integration site (Wnt)1 and c-myc in SCC9 cells treated with different IL-23 concentrations. After interferencing the β-catenin with small interfering RNA (siRNA), the expression of β-catenin, B-cell lymphoma-2 (Bcl-2), ATP-binding cassette sub-family G member 2 (ABCG2), and permeabilityglycoprotein (P-gp) in SCC9 was measured by Western blot analysis. The effect of IL-23 on the apoptotic resistance of SCC9 to cisplatin was examined by methyl thiazolyl tetrazolium test. Results  The expression of IL-23 in tongue cancer tissues was correlated with lymphatic metastasis, nerve invasion, and the recurrence after therapy (P<0.05). After dealing with IL-23, SCC9 showed the upregulation effect of Bcl-2, ABCG2 and P-gp expressions. IL-23 was closely related to the activation level of the Wnt pathway and significantly strengthened the resistance to cisplatin (P<0.01). Conclusion  IL-23 activates the Wnt pathway in tongue squamous cell carcinoma, thereby enhancing its resistance to apoptosis and drug.

    Integrated assessment of middle ear dysfunction in cleft palate patients and optimization of therapeutic schedule
    Jiang Wenrong, He Tao, Zheng Qian, Zheng Wei, Shi Bing, Yang Chao, Li Chenghao.
    West China Journal of Stomatology. 2015, 33(3):  255-258.  doi:10.7518/hxkq.2015.03.008
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    Objective  To explore evaluation strategies for middle ear dysfunction in cleft palate patients, to optimize the diagnosis and treatment of this dysfunction, and ultimately to improve the comprehensive treatment of cleft palate. Methods  The relationship among abnormal tympanic types (B, C, and Anomaly), effusion rate, tympanic pressure, and hearing loss were analyzed. We collected relevant information on 469 ears of cleft palate patients and traced one-year longitudinal changes in the tympana of 124 ears from 62 patients with both cleft lip and cleft palate. Results  The effusion rates of cleft palate patients with type B, type C, and type Anomaly were 50.3% (97/193), 34.8% (8/23), and 20.9% (53/253), respectively. The tympanic pressure of the ears with and without effusion showed no significant difference (P>0.05). The hearing loss in type B cleft palate patients with middle ear effusion was worse than that in patients without effusion (P=0.001). However, the hearing loss in type Anomaly showed no difference (P>0.05). The constituent ratio of each tympanic type remained constant during the period between cheiloplasty and palatoplasty for cleft lip and palate patients (P>0.05). Conclusion  Cleft palate patients of all tympanic types may all suffer from middle ear effusion at different rates. Examination by centesis is suggested for ears with abnormal tympanic types. Early aggressive therapy is essential for type B cleft palate patients with middle ear effusion to avoid hearing loss. However, catheterization may be not necessary for type Anomaly patients, and conservative observation should be performed instead. Myringotomy with grommet insertion during palatoplasty does not delay treatment timing for patients with both cleft lip and cleft palate.

    Clinical comparative study on the treatment characteristics of secretory otitis media between cleft and non-cleft palate patients
    Li Sen, Zhang Hong, Wei Yun, Zhang Xilei, Wu Yingru, Qian Jiang, Shen Liang, Zhang Zhengjian.
    West China Journal of Stomatology. 2015, 33(3):  259-262.  doi:10.7518/hxkq.2015.03.009
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    Objective  To discuss the treatment characteristics of secretory otitis media (SOM) in cleft palate children. Methods  A total of 319 patients (524 ears) with SOM and cleft palate (3-14 years old) who accepted treatment were divided into experiment group A, group B, and group C according to effusion characteristics in the middle ear and tympanic pressure. Group A included 112 patients with serous effusion (198 ears). Group B included 162 patients with mucinous effusion (248 ears). Group C included 45 patients (78 ears) with negative pressure in the middle ear without effusion and an acoustic immittance. A total of 208 patients (246 ears) with SOM and tonsil and adenoid hypertrophy were divided into control group A1, group B1, and group C1 matched with the same effusion characteristics in the middle ear and tympanic pressure. Group A and A1 accepted puncture in the tympanic cavity, group B and B1 accepted tympanostomy tubes, and group C and C1 accepted puncture in the tympanic cavity after palatoplasty, adenoidectomy, and tonsillectomy. All groups were treated with antibiotics and ear drops. Cure rate and recurrence rate between the experiment group and the control group were compared. Results  The control group had a better cure rate [93.09% (229/246)] than the experiment group [77.29% (405/524)] 12 months after treatment. The experiment group had a higher recurrence rate [14.57% (59/405)] than the control group [3.93% (9/229)]. Statistical differences were observed between the two groups (P<0.05). SOM with cleft palate initially had a low cure rate, and thus it was treated repeatedly for many times. Conclusion SOM with cleft palate is different from normal otitis media in terms of clinical manifestation, treatment, outcome, and prognosis. This case should be considered a special otitis media to be treated with special examination and therapy to obtain better results. Repeated puncture in the tympanic cavity and tympanostomy tubes for six months according to effusion characteristics are better treatment options for patients with SOM and cleft palate.

    Three years retrospective clinical evaluation of endodontically treated premolars restored by cast ceramic onlays
    Li Zhi, Gao Chengzhi, Xu Yongwei, Xu Jingling.
    West China Journal of Stomatology. 2015, 33(3):  263-266.  doi:10.7518/hxkq.2015.03.010
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    Objective  This study aimed to evaluate the success and survival rate of endodontically treated premolars restored by ceramic onlays by comparing restored by quartz fiber posts and metal ceramic crowns. Methods  Ninety-four patients with 126 endodontically treated premolars were enrolled in this study and divided into 4 groups according to the remaining axial walls and restorative methods. The observation time was 36 months. The success and survival rates of the restorations, as well as causes of failures, were analyzed. Results  At the final follow-up, the success and survival rates of the mild defect endodontically treated premolars were restored by quartz fiber posts and the crowns were at 96.3% and 98.1%; the success and survival rates of the severe defect premolars restored by quartz fiber posts and crowns were at 88.5% and 96.2%. The success and survival rates of the mild defect premolars restored by cast ceramic onlays were both at 96.6%, the success and survival rates of the severe defect premolars restored by cast ceramic onlays were at 94.1% and 100%, respectively. The success and survival rates of the different groups were no significant difference (P>0.05). Conclusion  Based on the results and within the limits of this study, cast ceramic onlays is a very reliable method to restore endodontically treated premolars.

    Stability of the anterior teeth and hard tissue of skeletal class Ⅲ malocclusion after orthodontic surgery: systematic review
    Li Xueyan, Deng Mengxuan, Yuan Xiaoping.
    West China Journal of Stomatology. 2015, 33(3):  267-271.  doi:10.7518/hxkq.2015.03.011
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    Objective  This study aims to analyze the long-term stability of the anterior teeth and hard tissue of skeletal class Ⅲ malocclusion after a three-year orthodontic surgery by systematic review. Methods  All studies about skeletal classⅢ malocclusion with orthodontic-surgery were searched by computer-based retrieval and manual retrieval; the deadline is December 2013. The literature, filtered according to the inclusion criteria and exclusion criteria, was performed with quality assessment. The same indicators of the anterior location and hard tissue stability were combined and evaluated with metaanalysis and descriptive analysis by Rev Man5.2. Results  Four before-and-after comparison study articles with 180 cases were included. The grades of the four literature evaluation were A. The meta-analysis results showed that comparing the threeyear post-orthodontic-surgery and post-orthodontic-surgery, the total weighted mean difference (WMD) of U1-SN was 4.29 (P<0.05); the WMD of L1-MP, OB, OJ, SNA, SNB, ANB, and MP-SN were-1.58, 0,-0.41,-0.58, 0.25,-0.70, and 0.39, respectively (P>0.05). The measurement methods of A and B point position were different, hence the qualitative description were as follows: point A remained at a relatively stable position, and point B had some replacement compared with postoperative (P<0.05). Conclusion  To the skeletal class Ⅲ malocclusion after three-year orthodontic-surgery, the position of the lower anterior teeth could be kept stable, as well as the overbite and the overjet of the anterior teeth; only the upper incisor has a lip-inclined relapse. The maxillary could also be kept stable, and the mandibular had a little relapse.

    Reconstruction of the orbital fracture with enophthalmos using customized titanium mesh combined with Medpor
    Sun Libo, Xiao Jingang, Lan Yuyan, Xiong Yilin, Zhang Li, Zhou Hangyu, Zhang Lei.
    West China Journal of Stomatology. 2015, 33(3):  272-275.  doi:10.7518/hxkq.2015.03.012
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    Objective  This study aims to evaluate the effect of customized titanium mesh, which was designed by mirror imaging and rapid prototyping technique, with Medpor applied for orbital fracture with enophthalmos. Methods  Orbital axial, coronal, and sagittal CT scan, and three-dimension CT examination were performed routinely in 18 cases of orbital fracture with enophthalmos preoperatively. Based on the CT data, prosthesis model was designed by reverse engineering and rapid prototyping technique. The customized titanium mesh and Medpor were applied for orbital reconstruction and enophthalmos correction. Orbital reduction and globe projection were evaluated by postoperative CT scan and clinical follow-up visits. Results  CT scans revealed that the customized titanium mesh with Medpor had great accuracy to reconstruct the orbital fracture and correct the enophthalmos in all patients without serious complications. The eye and facial appearance and function recovered significantly. No serious complication occurred in the operation and after operation. Conclusion  The customized titanium mesh, based on mirror imaging and rapid prototyping technique, can accurately reconstruct the orbital fractures with enophthalmos. The application of Medpor can effectively correct enophthalmos and eyeball mobility malformation.

    Chimeric deep circumflex iliac artery perforator flap for the simultaneous reconstruction of the composite oromandibular defect
    Chen Jie, Jiang Canhua, Min Anjie, Ren Hui, Gao Zhengyang, Jian Xinchun.
    West China Journal of Stomatology. 2015, 33(3):  276-280.  doi:10.7518/hxkq.2015.03.013
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    Objective  To evaluate the feasibility and outcomes of chimeric deep circumflex iliac artery perforator flap (DCIAPF) applied in the simultaneous reconstruction of the oromandibular defect. Methods  Six patients underwent simultaneous oromandibular reconstruction using DCIAPF following segmental mandibulectomy in Xiangya Hospital from March 2014 to July 2014. The skin paddle was designed to be centered on the pre-operative perforator mapping. Retrograde dissection was performed through the underlying abdominal wall to raise the skin paddle. The pedicle was isolated from the groin, and the iliac crest was cut. The deep iliac circumflex vessels were dissected until the skin paddle was reached. Finally, the donor site was strictly sutured layer by layer to avoid ventral hernia. Results  The skin paddles ranged from 3.5 cm×5.0 cm to 7.0 cm×10.0 cm. The length of the bone components was 5.0 cm to 11.0 cm. All donor sites closed primarily without skin grafting. DCIAPF was harvested successfully in five patients, except for one patient whose perforator originated from the superficial iliac circumflex vessels. An additional pair of anastomoses was performed. All iliac flaps survived. However, slight skinedge necrosis and exfoliation caused by flap thinning occurred in one patient and healed after pruning and dressing change. The heights of all alveolar ridges were significantly restored, and no serious donorsite complication was observed during the three to six months’ follow-up. Conclusion  DCIAPF is a reconstructive option for mandibular defects because of its adequate bone tissue and rich blood supply. Satisfactory alveolar ridge restoration greatly facilitates future denture retention. DCIAPF also has a great degree of mobility between the skin paddle and the bone component when applied in composite oromandibular defect reconstruction.

    Application of 1 212 anterolateral thigh myocutaneous flaps in the repair of oral and maxillofacial defects
    Ren Zhenhu, Wu Hanjiang, Tan Hongyu, Wang Kai, Gong Zhaojian, Zhang Sheng, Liu Jinbing, Zhu Zhaofu.
    West China Journal of Stomatology. 2015, 33(3):  281-285.  doi:10.7518/hxkq.2015.03.014
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    Objective  To examine the benefits of anterolateral thigh myocutaneous flaps in reconstruction of oral and maxillofacial defects. Methods  Patients were recruited from February 2002 to June 2013 in the Department of Oral and Maxillofacial Surgery of Central South University. All patients (1 185 patients, 1 212 transferred flaps) underwent reconstructive surgery employing anterolateral thigh myocutaneous flaps. Basic information for all patients including defect side, flap size and type, recipient vessel processing method, donor complications, and postoperative quality of life were recorded and statistically analyzed. Results  Among the 1 212 transferred flaps, 1 176 survived and 36 showed necrosis, for a survival rate of about 97.0%. No cases presented with local serious complications, and 90% of patients achieved good functional recovery and aesthetically acceptable results after reconstruction of oral and maxillofacial defects at various locations using anterolateral thigh myocutaneous flaps. The time for anastomosis of one vein was significantly less than that for two veins (P=0.000 3), which indicated one vein anastomosis could significantly reduce the operating time. The incidence of venous crisis, the survival rate after treatment, and the rate of venous crisis resulting in flap necrosis were comparable between the groups (P>0.05). Conclusion  Anterolateral thigh myocutaneous flaps can be easily obtained and provide a good amount of muscle for filling dead space and fascia lata. These flaps can meet the various requirements of oral and maxillofacial defects. Therefore, the anterolateral thigh myocutaneous free flaps are more suitable for oral and maxillofacial defects than other flaps.

    Evaluation of the stress distribution in tooth implant-supported fixed partial prostheses on different bone types under dynamic loads
    Zhang Yang, Wang Chao, Zhang Xiaonan, Xu Ling.
    West China Journal of Stomatology. 2015, 33(3):  286-290.  doi:10.7518/hxkq.2015.03.015
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    Objective This study aims to evaluate the influence of different bone types on the stress distribution in tooth implant-supported fixed partial prostheses by using finite element (FE) analysis. Methods Four FE models of mandibular arch containing one implant splinted to the mandibular second premolar were built according to bone types Ⅰ, Ⅱ, Ⅲ, and Ⅳ. Dynamic loads of 250 N were applied to the buccal and lingual cusps of the prostheses in different directions to simulate the masticatory cycle. The maximum Von Mises stresses were calculated using the FE analysis software. Results The maximum Von Mises stresses of the cortical bones were 89.229, 91.860, 125.840, and 158.420 MPa, increasing from type Ⅰ to type Ⅳ, respectively. The maximum Von Mises stresses of the trabecular bone were 58.584, 43.645, 21.688, and 18.249 MPa, decreasing from type Ⅰ to type Ⅳ, respectively. During the process of dynamic loading, the maximum Von Mises stresses of the cortical and trabecular bones followed the order buccal to tongue loading>tongue to buccal loading>vertical loading. Conclusion The results showed that bone type significantly influenced the stress distribution in bones, and that for tooth implant-supported fixed partial prostheses, bone types Ⅰ and Ⅱ were a better choice than bone types Ⅲ and Ⅳ. More caution should be exercised when restoring missing teeth using tooth implant-supported fixed partial prostheses in softer bone regions.

    Three-dimensional finite element analysis of maxillary anterior teeth retraction force system in light wire technique
    Zhang Xiangfeng, Wang Chao, Xia Xi, Deng Feng, Zhang Yi.
    West China Journal of Stomatology. 2015, 33(3):  291-295.  doi:10.7518/hxkq.2015.03.016
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    Objective  This study aims to construct a three-dimensional finite element model of a maxillary anterior teeth retraction force system in light wire technique and to investigate the difference of hydrostatic pressure and initial displacement of upper anterior teeth under different torque values of tip back bend. Methods  A geometric three-dimensional model of the maxillary bone, including all the upper teeth, was achieved via CT scan. To construct the force model system, lingual brackets and wire were constructed by using the Solid works. Brackets software, and wire were assembled to the teeth. ANASYS was used to calculate the hydrostatic pressure and the initial displacement of maxillary anterior teeth under different tip-back bend moments of 15, 30, 45, 60, and 75 Nmm when the class Ⅱ elastic force was 0.556 N. Results  Hydrostatic pressure was concentrated in the root apices and cervical margin of upper anterior teeth. Distal tipping and relative intrusive displacement were observed. The hydrostatic pressure and initial displacement of upper canine were greater than in the central and lateral incisors. This hydrostatic pressure and initial intrusive displacement increased with an increase in tip-back bend moment. Conclusion  Lingual retraction force system of maxillary anterior teeth in light wire technique can be applied safely and controllably. The type and quantity of teeth movement can be controlled by the alteration of tip-back bend moment.

    Reliability of iWitness photogrammetry in maxillofacial application
    Jiang Chengcheng, Song Qinggao, He Wei, Chen Shang, Hong Tao.
    West China Journal of Stomatology. 2015, 33(3):  296-300.  doi:10.7518/hxkq.2015.03.017
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    Objective  This study aims to test the accuracy and precision of iWitness photogrammetry for measuring the facial tissues of mannequin head. Methods  Under ideal circumstances, the 3D landmark coordinates were repeatedly obtained from a mannequin head using iWitness photogrammetric system with different parameters, to examine the precision of this system. The differences between the 3D data and their true distance values of mannequin head were computed. Results  Operator error of 3D system in non-zoom and zoom status were 0.20 mm and 0.09 mm, and the difference was significant (P<0.05). Image captured error of 3D system was 0.283 mm, and there was no significant difference compared with the same group of images (P>0.05). Error of 3D system with recalibration was 0.251 mm, and the difference was not statistically significant compared with image captured error (P>0.05). Good congruence was observed between means derived from the 3D photos and direct anthropometry, with difference ranging from −0.4 mm to +0.4 mm. Conclusion  This study provides further evidence of the high reliability of iWitness photogrammetry for several craniofacial measurements, including landmarks and interlandmark distances. The evaluated system can be recommended for the evaluation and documentation of the facial surface.

    Study on the antibacterial activity of four kinds of nano-hydroxyapatite composites against Enterococcus faecalis
    Liu Yi, Zhou Rongjing, Wu Hongkun.
    West China Journal of Stomatology. 2015, 33(3):  301-305.  doi:10.7518/hxkq.2015.03.018
    Abstract ( 802 )   HTML ( 4 )   PDF(pc) (866KB) ( 548 )   Save
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    Objective  This study aims to compare and determine a kind of nano-hydroxyapatite composite material with good antibacterial efficacy on Enterococcus faecalis (E. faecalis) in vitro. Methods  We investigated the antimicrobial activity of four kinds of nano-hydroxyapatite composites, namely, silver/hydroxyapatite composite nanoparticles (Ag/nHA), yttrium/hydroxyapatite composite nanoparticles (Yi/nHA), cerium/hydroxyapatite composite nanoparticles (Ce/nHA), and hydroxyapatite nanoparticles (nHA), against E. faecalis in vitro using the agar diffusion and broth dilution method by measuring the growth inhibition zone and the minimum inhibitory concentration (MIC), respectively. Results  The agar diffusion test results showed that Ag/nHA displayed an obvious growth inhibition zone, whereas Yi/nHA, Ce/nHA, and nHA showed no influence on E. faecalis. The MIC value of Ag/nHA was 1.0 g·L-1, and the three other materials had no effect on E. faecalis even at the high concentration of 32.0 g·L-1. Conclusion  Ag/nHA display a potential antimicrobial efficacy to planktonic E. faecalis. Whereas, the three other kinds of nano-hydroxyapatite composites (Yi/nHA, Ce/nHA, nHA) show no influence.

    Effect of different dentin cleaning agents on the bond strength of self-adhesive resin cement to dentin
    Jiao Jilan1, Zeng Liwei1, Zhou Hao2, Deng Lu1, Zhou Niangou1, Chen Ping1, Jiang Hui1.
    West China Journal of Stomatology. 2015, 33(3):  306-310.  doi:10.7518/hxkq.2015.03.019
    Abstract ( 2214 )   HTML ( 4 )   PDF(pc) (868KB) ( 706 )   Save
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    Objective  This study aims to evaluate the bond strength of a self-adhesive resin cement to dentin by ethylenediamine tetraacetic acid (EDTA) and NaClO. Methods  Twenty-seven freshly extracted non-carious human premolars were prepared to expose the buccal dentin and randomly divided into three groups: control group (A group), EDTA group (B group) and NaClO group (C group). All teeth were bonded to dentin using a self-adhesive resin cement after the teeth in the A group were processed with distilled water. The B and C group were processed with 3%EDTA and 1%NaClO, respectively. After 24 hours at 37 ℃ water, the shear bond strengths of the twenty-four specimens were measured. All statistical analysis was performed using SPSS 17.0 software package. Each fractured specimen was examined under dental microscope. Three new specimens were cut, and the morphologies of the cement-dentin interface were observed under scanning electron microscope (SEM). Results  The shear bond strength in the A group, B group and C group was (8.55±0.63), (8.47±0.56) and (12.97±0.59) MPa, respectively. The difference between A group and B group was no statistically significant (P>0.05), whereas the difference between C group and B group (or A group) was statistically significant (P<0.05). SEM observation of the cementdentin interface in the C group showed good adaptation, but resin tags were not observed. The other two groups showed poor bonding interface. Most of the fractured adhesive dentin surfaces exhibited cohesive failure in the A group and B group. All the fractured adhesive dentin surfaces exhibited cohesive failure in the C group. Conclusion  1% NaClO can increase the bond strength of self-adhesive resin cement to dentin, but 3%EDTA has no effect.

    Analysis of different endodontic sealers and strategies of root canal irrigation on the bond strength of fiber posts
    Zhu Shujin, Liu Cuiling, Zheng Zheng, Yang Liyuan, Gao Xu.
    West China Journal of Stomatology. 2015, 33(3):  311-314.  doi:10.7518/hxkq.2015.03.020
    Abstract ( 954 )   HTML ( 12 )   PDF(pc) (896KB) ( 587 )   Save
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    Objective  To evaluate the influence of eugenol-containing and resin-containing endodontic sealers on the bond strength of fiber posts using different strategies of root canal irrigation. Methods  Forty-eight mandibular premolars were endodontically treated. The specimens were randomly assigned into two groups according to different endodontic sealers. Group A used Endofil (eugenol-containing endodontic sealer), and group B used AH-plus (resin-containing endodontic sealer). After post space preparation, each group was randomly assigned into three subgroups according to the strategies of root canal irrigation (eight premolars in each subgroup). Group A1 and B1:0.9%NaCl irrigation; Group A2 and B2:17% ethylene diamine tetraacetic acid (EDTA)+5.25%NaClO+0.9%NaCl irrigation; Group A3 and B3: ultrasonic agitation associated with 1 7%EDTA+5.25%NaClO+0.9%NaCl. One week after the cementation of fiber posts using RelyXTM Unicem, a push-out test was performed to measure the bond strength of the posts. The microstructure of the root canal surface was examined under scanning electron microscope (SEM). Results  The bond strengths of the six groups were as follows: A1 (7.96±2.23) MPa, A2 (9.95±2.89) MPa, A3 (18.88±3.69) MPa, B1 (11.41±3.71) MPa, B2 (14.00±4.04) MPa, and B3 (19.14±3.27) MPa. Statistical analysis revealed a significant interaction between the different endodontic sealers and the strategies of root canal irrigation (P<0.05). Lower bond strength was found in group A1 but not in group B1 (P<0.05), and the same result was revealed when comparing group A2 and B2. No significant difference was observed between group A3 and B3 (P>0.05). SEM showed that the root canal in group A3 and B3 achieved the cleanest surface with nearly all dentine tubules opened. Conclusion  The eugenol-containing endodontic sealer can impair the bond strength of fiber posts compared with the resin-containing sealer when the root canal is irrigated by 0.9% NaCl or 17%EDTA+5.25%NaClO+0.9%NaCl. No difference was observed between the two sealers when using 17%EDTA+5.25% NaClO+0.9%NaCl combined with ultrasonic irrigation.

    Precision stomatology: current status and challenges
    Xu Xin, Zheng Xin, Zheng Liwei, Cheng Lei, Zhou Xuedong.
    West China Journal of Stomatology. 2015, 33(3):  315-321.  doi:10.7518/hxkq.2015.03.021
    Abstract ( 922 )   HTML ( 11 )   PDF(pc) (1002KB) ( 917 )   Save
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    The completion of human genome project and the progress in medical practice have inevitably lead to the development of precision medicine, which is a medical model that proposes the customization of medical care including medical decisions, practices, and/or medical products with patient’s genetic background, environmental factors and life behavior being taken into account. The current work proposed precision stomatology for the first time, and by integrating data reported in recent literature, we described the current practice of precision stomatology in multiple disciplines in modern dentistry. The clinical significance of precision stomatology and its future challenges have also been discussed.

    Application of surgical navigation technology in the treatment of zygomatic fracture
    Ye Lanfeng, Li Kaide, Liu Lei.
    West China Journal of Stomatology. 2015, 33(3):  322-325.  doi:10.7518/hxkq.2015.03.022
    Abstract ( 611 )   HTML ( 4 )   PDF(pc) (862KB) ( 700 )   Save
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    Zygomatic fracture is one of the most common mid-facial fractures. Zygomatic fracture often leads to openmouth and chewing dysfunctions, which are often associated with pronounced zygomatic facial deformity, causing psychological and physiological problems in patients. The complicated anatomical structures associated with zygomatic fracture often make treatment difficult. Surgical navigation technology provides a new auxiliary method for improving the treatment results for zygomatic fracture. This review aims to provide a comprehensive overview of the application of surgical navigation technology in the treatment of zygomatic fracture.

    Perforated maxillofacial defect repaired by anteromedial thigh flap instead of anterolateral thigh flap: a case report
    Sun Haibin, Li Bo, Li Chunjie, Men Yi, Gao Ning, Li Longjiang.
    West China Journal of Stomatology. 2015, 33(3):  326-328.  doi:10.7518/hxkq.2015.03.023
    Abstract ( 568 )   HTML ( 7 )   PDF(pc) (809KB) ( 604 )   Save
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    Anterolateral thigh flap is perfect for reconstructing maxillofacial soft tissue defects. This tissue has been widely used by clinicians, but often causes operation difficulties because of vascular variation. In this paper, we report a case where anteromedial thigh was used as new donor site when the vascular anatomic variation of anterolateral thigh perforator flap induced a failure in the flap harvest. Moreover, this paper discusses the anatomy and application of anteromedial thigh flap.

    Maxillary first molar with twin-root canal in palatal side: two case reports  
    Wu Di, Wu Hongbin.
    West China Journal of Stomatology. 2015, 33(3):  329-330.  doi:10.7518/hxkq.2015.03.024
    Abstract ( 945 )   HTML ( 5 )   PDF(pc) (702KB) ( 822 )   Save
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    Maxillary first molar with twin-root canal in palatal side is rare. This article described two cases of maxillary first molar with twin-root canal. A properly designed and prepared access of the cavity is helpful for the diagnosis and negotiation of the root canal morphology.