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PURPOSE: To observe the haematological and histological changes by establishing total temporomandibular joint (TMJ) replacement model in sheep, and to evaluate the biological safety of domestic total TMJ prosthesis. METHODS: Ten healthy sheep were included in this study and six of them were as the experimental group. Spiral computed tomography (CT) data of the six sheep was obtained and transformed into 3-dimensional model by Surgicase 5.0 software preoperatively. Total TMJ prostheses were made based on the skull model. Ultra -high molecular weight polyethylene was used to make glenoid fossa lining, while titanium alloy was used to prefabricate mandibular retention handle and titanium plate over glenoid fossa and cobalt-chromium-molybdenum alloy to prefabricate condyle. The other four sheep were as normal control group. The condyles and discs on the right side of the six experimental animals were resected and total TMJ replacements were performed. Serum both from the experimental and control groups before and after operation was collected to detect the liver and kidney function. HE and TUNEL staining were performed on liver and kidney and HE staining performed on the bone of the mandibles three and six months after operation. The experimental and control groups were compared by t test using SPSS16.0 software package. RESULTS: All animals were alive to the end of experiment with good recovery of masticatory function and normal eating. There were no significant differences of liver and kidney function between the two groups at every time point. No obvious pathological changes and apoptotic rate were observed. Osteocytes on the experimental side were increased 3 months after operation and decreased at six-month. CONCLUSION: Domestic total TMJ prosthesis showed good biocompatibility and had no cacoethic effect on the animals. Supported by National Natural Science Foundation of Shanghai Municipality (10ZR1418200), and Shanghai Pujiang Talent Plan in 2011. [ABSTRACT FROM AUTHOR]

Temporomandibular joint osteoarthrosis (TMJOA) is one of the most frequently-occuring TMJ diseases. It can result in symptoms such as limitation of mouth opening, pain in the TMJ and friction, which severely affect the quality of life for patients or even become life-threatening. Anterior disc displacement is the most common structural problem in the internal derangement, the prevalence of which is reported as high as 80%. Recently with the development of imaging technique and, finding out the relationship between these two diseases will have great impact on the treating strategy. This review summarized the current literature on correlation between anterior disc displacement (ADD) and temporomandibular joint osteoarthrosis. [ABSTRACT FROM AUTHOR]

Recently, implant surgery has become a common clinical technique. As the improvement of implant design and surgery, the success rate of implant surgery has been increased and the indication has also been widened. However, the inadequate height of residual bone is still the main factor influencing implant surgery in maxillary posterior region. Lateral window technique of maxillary sinus floor and the transalveolar maxillary sinus floor elevation are used to solve the problem of bone inadequacy and widen implant indication in related region. This paper mainly introduced the structure of sinus and septa, the application of oral radiology examination; summarized the basic principle of maxillary sinus floor augmentation, incision design and operative method of the lateral window technique, comparison of three different advanced technique of transalveolar elevation, the characters of osteotomes, and investigated bone materials, special equipments (piezosurgery and endoscopic), treatment options of implant surgery with maxillary sinus cyst and postoperative complications. [ABSTRACT FROM AUTHOR]

PURPOSE: To introduce and evaluate the preliminary application of piezosurgery in oral implant surgery. METHODS: Six patients have been diagnosed as bone deficiency in implant sites through preoperative evaluation from Feb. 2012 to Jun. 2012. Two patients with residual bone height of 4 to 6 mm from the alveolar ridge crest to sinus floor in maxillary posterior region, were treated with lateral window technique of maxillary sinus. The other four patients with the residual bone width of 3 ~6 mm in maxillary or mandibular anterior region were treated with labial onlay bone graft technique. Piezosurgery was used for lateral window technique to finish maxillary sinus floor augmentation and mandibular ramus external oblique line graft to finish labial onlay bone graft in the operation. RESULTS: The operations were successfully completed for all six patients. During the operation, piezosurgery had a good capability to cut both cortical and cancellous bone, and had the advantage of high accuracy, soft tissue protection, less bleeding, clear operative vision and minimum trauma. Dizziness and headache didn't happen after operation, and all incisions healing primarily. Panoramic images and CT examinations showed that the incisions healing of anterior wall of maxillary anterior wall and mandibular ramus external oblique line were good, and the ossification of bone materials and block bone were also good after 3 and 6 months. CONCLUSION: Piezosurgery possesses favorable bone cutting ability, soft tissue protection, and thus has a broad prospect in oral implant surgery. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the effect of functional treatment for disk displacement with reduction (DDWR) of the temporomandibular joint (TMJ). METHODS: Fifty-seven juvenile patients (78 joints) diagnosed as DDWR underwent functional treatment. MRIs were used before and after functional treatment. The disk position was judged according to the success criteria which included all sagittal planes after treatment. Those patients, whose disk of TMJ was in normal position with remarkable condylar remolding, were evaluated to be excellent. If normal disk-condyle relationship with no remarkable condylar remolding or mild disk displacement with disk-like structure of the bilaminar zone were found, the outcome was evaluated to be good. Compared with pre-treatment, if the disk position was the same or became worse, the outcome was evaluated to be poor. Cases evaluated as "excellent" and "good", were considered as successful. RESULTS: MRI for all joints confirmed that 73.08% (57/78) were excellent; 14.10% (11/78) were good, and only 12.82% (10/78) were poor. The total effective rate was 87.18% (68/78). The effective rate for anterior repositioning splint therapy was 84.09%, 87.50% for twin-block appliance, and up to 94.44% for the Herbst functional appliance. Arthroscopic surgery or open surgery was carried out for the joints which were evaluated as poor. CONCLUSION: This study indicates that functional appliance is effective in repositioning the DDWR confirmed by MRI examination, but long-time follow-up is necessary for the evaluation of its stability. Supported by Research Fund for Young College and University Teachers from Shanghai Municipal Education Commission (jdy11027). [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the mandibular symmetry after temporomandibular joint (TMJ) replacement by Surgicase5.0 software in developmental stage sheep. METHODS: Six developmental stage sheep were included in our study. Spiral computed tomography (CT) data of all six sheep was obtained and transformed into 3-dimensional model by Surgicase5.0 software preoperatively. 3 -dimensional resin skull models of sheep were obtained by rapid prototyping technique, based on which total TMJ prostheses were made and surgical planning and simulation were achieved by Surgicase5.0 software. The right sides, which were as the experimental group, of all six sheep underwent operation based on preoperative planning, while the left sides as control group. CT scanning was performed one week, four and twelve weeks after operation. Ramus heights (RH), mandibular body length (ML), condyle-incisor (CI) and subramental-condyle (BC) of both experimental and control group were measured and compared by paired t test. Meanwhile those measurements before and after operation on experimental or control group were compared by paired t test using SPSS16.0 software package. RESULTS: All animals were alive to the end of experiment with good recovery of masticatory function and normal eating. There was no significant difference between the experimental and control groups for any parameter of RH, ML, CI, BC after one week or four weeks. There were significant difference for RH, CI, BC except ML after twelve weeks. The comparison before and after operation on experimental group showed that there were no significant difference on RH, ML, CI, BC after one week, RH, BC after four weeks and RH after twelve weeks. Comparison before and after operation on the control group showed that there was no significant difference on RH, ML, CI, BC after one week and RH after four weeks. CONCLUSIONS: The function of natural TMJ of sheep can be well reconstructed by personally designed total TMJ prosthesis. Total TMJ replacement in developmental stage sheep may result in mandibular asymmetry. Supported by Shanghai Leading Academic Discipline Project (S30206), Shanghai Pujiang Talent Plan in 2011 and Natural Science Foundation of Shanghai Municipality(10ZR1418200). [ABSTRACT FROM AUTHOR]

Temporomandibular joint osteoarthrosis (TMJOA) is one of the most frequently-occurring diseases. It can result in symptoms such as limitation of mouth opening, pain in the TMJ and frication, which severely affect the quality of life of patients or even become life-threatening. Recently,with the development of imaging technique and, diagnosis and treatment of TMJOA continue to improve and perfect. This review summarized the current literature on diagnosis and treatment progress of temporomandibular joint osteoarthrosis. Supported by Shanghai Leading Academic Discipline Project (S30206), Shanghai Pujiang Talent Plan, Research Fund of Shanghai Municipal Health Bureau (2008160)and Natural Science Foundation of Shanghai Municipality(10ZR1418200). [ABSTRACT FROM AUTHOR]

PURPOSE: To introduce a modified anchor technique for internal derangement of temporomandibular joint (TMJ). METHODS: One hundred seventy -seven patients (232 TMJs) diagnosed as TMJ internal derangement (ID), through clinical examinations and MRI, were treated with a modified anchor technique from July 2011 to March 2012. The technique is mainly proposed for TMJ ID. The approach was to put an anchoring nail in the middle of the inclined surface, just below the posterior oblique surface of the condyle and use two 3-0 Nylon sutures to fix disc to the anchoring nail. Both preoperative and postoperative MRIs were taken to define the disc position. For patients with malocclusion or irregular dentition, reposition biting plate and orthodontic treatment were also conducted. RESULTS: Among 232 joints of postoperative MRIs, 226 joints (172 cases) were classified as excellent and 4 joints (4 cases) were good, only 2 joints (1 case) were poor which needed a second open surgery. The total effective rate was 99.14%. CONCLUSION: The modified procedure provided successful results in the treatment of TMJ ID. The design was more reasonable, but further clinical evaluation is necessary. Supported by Shanghai Leading Academic Discipline Project (S30206), Research Project of Shanghai Municipal Bureau of Health (2008160), Doctorate Foundation of the Ministry of Education of China (20090073110068), National Natural Science Foundation of Shanghai Municipality (10ZR1418200)and Shanghai Pujiang Talent Plan in 2011. [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze the synovial fluid, and explore the significance of fibrin during the formation of intra-articular adhesion (IA). METHODS: Arthroscopic disc repositioning and suturing was performed on patients with temporomandibular joint (TMJ) internal derangement (ID) ranging from stage II to V who visited the TMJ clinic at the Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, between Dec. 27, 2007 and Jun. 16, 2008. The patients' ID stages were classified based on the criteria of Wilkes & Bronstein's classification. 125 samples of synovial fluids were collected before arthroscopic surgery and stored in cold environment. According to the fluorescence intensity of each sample, and the immunofluorescence confocal laser microscopic semi-quantitative analysis was used to determinate the content of fibrin. Student's t test was performed using SPSS16.0 software package, to compare the difference of the average fluorescence intensity of joint fluid in different groups (ID stage, different age, different sex and different joints). RESULTS: There was statistically significant difference in the synovial fluid immune fluorescence intensity in different sex and age group. The average synovial fluid immune fluorescence intensity of all 125 samples was 4.43±3.67 (0-31.68). The average immune fluorescence intensity of each stage was stage II: 2.38±1.17, stage M: 4.68± 3.98, stage IV: 4.80±2.80 and stage V: 3.58±2.64. There was significant difference between the results of stage II and stage HI (P=0.0065<0.05), and there was significant difference between the results of stage II and stage IV (P=0.0207< 0.05). The average immune fluorescence intensity of the male group was 4.05±2.70 and the female group was 5.57±4.71. There was significant difference between the results of male group and female group. The average immune fluorescence intensity of the synovial fluid of left TMJ was 4.37±3.04 and the right TMJ was 5.97±5.20. There was significant difference between the results of the left and right TMJ synovial fluids. The average immune fluorescence intensity of group 1 was 4.55±2.45, group 2 was 4.56±3.39, group 3 was 2.60±1.12 and group 4 was 5.68±6.71. There was significant difference between group 1 and group 3, group 2 and group 3, group 3 and group 4. CONCLUSION: The average intensity of TMJ increased with ID stage, which confirmed that fibrin in synovial fluid is one of the important protein factors during the formation of IA, and verified our hypothesis about the formation of IA. Supported by Shanghai Leading Academic Discipline Project (S30206), Grant from Shanghai Municipal Bureau of Health (2008160), Natural Science Foundation of Shanghai Municipality (10ZR1418200), Ph.D. Programs Foundation of Ministry of Education of China (20090073110068), and Natural Science Foundation of Henan Province (2010C320006). [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the effect of arthroscopic disc suturing for treating internal derangement of the temporomandibular joint (TMJ). METHODS: Arthroscopic disc repositioning and suturing surgery was performed on patients who visited the TMJ clinic at the Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, between May 2001 and May 2006 with stages II-V TMJ ID. The patients' ID stages were based on the criteria of Wilkes & Bronstein's classification. Consecutive MRIs were used to evaluate ID before operation and after operation for all 911 patients (1103 joints). The disc position was judged according to our success criteria which included three different sagittal planes (lateral, central and medial). Arthroscopic surgery or open surgery was carried out once more for the joints evaluated as poor. RESULTS: Postoperative consecutive MRIs for all 1103 joints confirmed that 93.56% (1032/1103) joints were excellent or good, and only 6.44% (71/1103)were poor. The average follow-up period for clinical evaluation was 15.3 months (2 to 29 months), 32.88% (48/146) was excellent, 57.53% (84/146) was good, 9.59% (14/146) was poor, the total effective rate was 90.41% (132/146). 92.47% (135/146) of the patients feels more comfortable after the operation. The effective group had an improvement in mouth opening of (14.34±5.87)mm (P<0.001). The preoperative VAS value was 29.76±23.35 (0-80), while it decreased to 3.71+7-91 (0-50) postoperatively (P<0.05). The non-effective group had no significant improvement in mouth opening (P>0.05). The preoperative VAS value of this group was 3.33±5.77 and 36.67± 30.55 postoperatively (P<0.01). There was no significant difference between MRI and clinical evaluation (P>0.05). CONCLUSION: TMJ arthroscopic suturing technique is an effective, minimally invasive surgery in repositioning the TMJ disc, but long-term follow-up is necessary for the evaluation of its stability. Supported by Shanghai Leading Academic Discipline Project (S30206), Research Fund of Shanghai Municipal Bureau of Health (2008160), Shanghai "Phosphor" Science Foundation (04QMH1415), National Natural Science Foundation of China(81070848), Natural Science Foundation of Shanghai Municipality (10ZR1418200), Ph.D. Programs of Ministry of Education of China (20090073110068), and Natural Science Foundation of Henan Province (2010C320006). [ABSTRACT FROM AUTHOR]

Writing and publishing papers is the last step of scientific research, and also the main approach for academic disclosure and exchange. Publication of high quality SCI cited papers is one of the important criteria to accredit research capacity and academic level for a personnel, team and institution, which requires novel topics, solid professional theory and knowledge, essential statistical expertise, and superior writing competence in English as a systemic procedure. This paper highlighted the complete process of writing, submitting, and publishing SCI cited papers in stomatology, offering insight into some key points in each step based on the authors' experiences. It is deemed to help readers and relevant physicians who are preparing to publish SCI cited medical papers. [ABSTRACT FROM AUTHOR]

PURPOSE: To discuss the application of CAD/CAM technique in the treatment of condylar osteochondroma accompanying with oral-maxillofacial bone deformity. METHODS: Pre-operational planning of a patient with condylar osteochondroma was conducted, maxillary and mandibular bone deformities was performed with CAD technique (Surgicase CMF 5.0 based on CT data), including virtual tumor resection, virtual osteotomy, virtual occlusal plate/osteotomy template designing and post -operative simulation. RP technique was used to make occlusal plates and osteotomy templates. Postoperative CT scan was performed and merged with the operation plans to evaluate the accuracy. RESULTS: Postoperative CT showed the effect of the operation matched with the preoperative planning well. The face of the patient was symmetrical 6 months after operation, there was no sign of recurrence. CONCLUSIONS: The pre -operative application of CAD/CAM technique can improve the accuracy of the tumor resection of the condyle and the correction procedure of facial asymmetry, as well as saving operating time. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (08DZ2271100), Research Fund of Biomedicine Engineering of Shanghai Jiao Tong University (YG2009MS42) and Program for Innovative Research Team of Shanghai Municipal Education Commission. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this study was to detect the changes in microstructure and ultrastructure of the synovial tissue in rabbit temporomandibular joint (TMJ) internal derangement (ID) model. METHODS: One to four weeks after establishment of rabbit TMJ ID model, synovial tissue was collected and examined by light and electron microscope to observe the microstructure and ultrastructure changes, CD34 was used to count small blood vessels. Paired t test was performed with SPSS 16.0 software package to compare the number of vessels in synovial tissue of the experimental side and the control side. RESULTS: One week after the establishment of the model, the average number of small blood vessels in the experimental side was 9.77±1.59, while the average number on the control side was 3.46±0.52. There was significant difference between the two groups (P=0.000). Two weeks later, the average number of small blood vessels in the experimental side was 15.15±2.88; while the number was 3.38 ± 0.65 on the control side. There was significant difference between the two groups (P=0.000). On the control side, there was no significant difference (P=0.721) for the number of small blood vessels in the second week, while there was significant difference on the experimental side in the second week (P=0.000). Numerous synovial cells of type A and type B can be detected in synovial tissue under electron microscopy, and type A cells shrink after a period of time. CONCLUSION: This study is helpful to understand the generation and development of the TMJ intraarticular adhesion (IA). Supported by Shanghai Leading Academic Discipline Project (S30206), Research Fund of Shanghai Municipal Bureau of Health (2008160), Natural Science Foundation of Shanghai Municipality (10ZR1418200), and Natural Science Foundation of Henan Province (2010C320006). [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze the complications of arthroscopic surgeries in the temporomandibular joint (TMJ), and investigate the preventive and treating methods. METHODS: In this study, Consecutive 2034 patients (2431 joints) diagnosed as TMJ internal derangement (ID) were treated by arthroscopic surgeries from May 1997 to Sept. 2009 in our department. The clinical complications were analyzed for investigating its cause, prevention and control measures. RESULTS: Of all 2034 cases, the complications were shown as follows. 5 joints hemorrhage of lateral pterygoid muscle vascular, injuries of lateral pterygoid muscle nerve in 5 joints, 3 joints with broken instruments, rejection reaction in 2 joints, perforation of tympanic membrane in 2 joints. CONCLUSION: Arthroscopic surgery was a safe and effective method to treat TMJ ID, its complications were limited and acceptable, but experienced operator was required for this surgical technique. Supported by Shanghai Leading Academic Discipline Project (S30206), Natural Science Foundation of Shanghai Municipality (10ZR1418200), and Ph.D. Programs Foundation of Ministry of Education of China (20090073110068). [ABSTRACT FROM AUTHOR]

Problem-based learning (PBL) is a widely accepted educational format centered on the discussion and learning that emanates from a clinically-based problem. Appropriate cases are key factors to ensure the successful implementation of PBL for medical students. Little is reported in PBL case-writing in the literature. This paper describes the design and principles of writing a PBL case based on a clinical problem (ameloblastoma of the jaw), which is intended to provide a learning focus for undergraduate dental students throughout the system-specific blocks. A good PBL case should allow for progressive, interdependent actions to be taken in the evaluation and ultimate management of the patient in the context, and trigger enquiry and discussion from the students in the aspects of both basic medical sciences (anatomy, physiology, biochemistry, pharmacology and pathophysiology, etc) and related clinical sciences. The epidemiological, sociological and ethical considerations contained within each problem should also be emphasized as an essential component of effective health care provision in our society. [ABSTRACT FROM AUTHOR]

PURPOSE: To introduce a surgical treatment of advanced TMJ internal derangement—disc replacement with temporalis myofascial flap pedicled on middle temporal artery and vein. METHODS: 48 patients with TMJ ID who underwent the disc replacement with TMF pedicled on the middle temporal artery and vein from July 2005 to December 2008 were involved in the study. TMF supplied by the branch of superficial temporal artery and vein-middle temporal artery and vein, was transferred into the joint space after excision of the disc. RESULTS: All operations completed successfully. Postoperative MRI showed that the joint space filled with mixed-signal material, the condyle and glenoid fossa were completely separated. CONCLUSION: TMF pedicled on the middle temporal artery and vein was a good disc substitute. [ABSTRACT FROM AUTHOR]

PURPOSE: To identify the vascular endothelial growth factor receptors (VEGFRs) expression in the rabbit synoviums with temporomandibular joint (TMJ) internal derangement (ID). METHODS: Real-time PCR was used to detect VEGF receptor expression in synovium, after establishing the rabbit TMJ ID model for 1, 2, 3, or 4 weeks. VEGFRs mRNA expression was normalized by comparing VEGFRs mRNA with internal control GAPDH. SPSS13.0 software package was used for comparison of the differences between the two groups. RESULTS: In the first and fourth week, significant difference was observed in VEGFR-2 mRNA expression between the experimental group and control group; however, no statistical difference was found in VEGFR-1 and VEGFR-3 mRNA expression between the experimental group and control group. In the second and third week, there were no statistical differences in VEGFR-1, VEGFR-2, and VEGFR-3 mRNA expression between the experimental group and control group. CONCLUSION: VEGFR-2 may play an important role in TMJ ID and adhesion formation. Specific VEGFR-2 inhibitors may be used to prevent adhesion formation in TMJ ID. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (Grant No. 08DZ2271100), Grant of Shanghai Leading Academic Discipline Project (Grant No.S30206), Grant of Shanghai Municipal Bureau of Health (Grant No.2008160), Grant from Shanghai "Phosphor" Science Foundation (Grant No.04QMH1415), Grant from Ph.D. Creative Foundation of Shanghai Jiao Tong University School of Medicine (Grant No.BXJ0926), and Research Fund of Medicine and Engineering of Shanghai Jiao Tong University (Grant No.YG2009MS42). [ABSTRACT FROM AUTHOR]

PURPOSE: The study aims to evaluate the value of panoramic films in diagnosis of condylar fractures. METHODS: Panoramic films of 163 cases (220 joints) diagnosed as condylar fractures by CT were examined. Panoramic films of all types of condylar fractures classified by CT were analyzed. According to the position of fracture, the samples were divided into two groups, intracapsular fractures and extracapsular fractures(condylar neck fractures and subcondylar fractures). The detection of fractures in two groups were compared and statistically analyzed with SAS6.12 software package. RESULTS: All 163 condylar fractures (220 joints) could be classified by CT as intracapsular fractures (155 joints), neck fractures (45 joints) and subcondylar fractures (20 joints). Panoramic films showed 38 joints without fractures and 182 joints with fractures. Among them, 33 joints without fractures and 122 joints with fractures were in the group of intracapsular fractures. The detection rate of intracapsular fractures group was significantly lower than that of condylar neck fractures and subcondylar fractures group (P=0.0149). CONCLUSION: Panoramic films can initially diagnose condylar fractures, but the misdiagnosis rate is high for intracapsular fractures, particularly for minor fractures and fractures without fragment displacement. CT should be considered for positioning of fracture lines and confirming the displacement angle of fragment on coronal plane. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (Grant No.08DZ2271100). [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the clinical characteristics and treatment results of condylar fractures. METHODS: A retrospective study was conducted in 339 patients (461 sides) with condylar fractures on the sex, age, cause, fracture characteristics, concomitant injury, etc. RESULTS: Condylar fractures occurred mainly in the male, especially over 18 years, the male to female ratio was 1.73:1. Fall (69.32%) was the leading cause of condylar fractures. Intracapsular condylar fracture (67.24%, 219 cases and 310 sides) was the most fracture site. Mental fracture was the main concomitant injury, up to 24.48%. CONCLUSIONS: Fall was the main cause of condylar fracture, and fracture occurred mainly in young and adult males. Most fractures were unilateral. [ABSTRACT FROM AUTHOR]

PURPOSE: To introduce arthroscopic treatment of adhesion and evaluate the effect of arthroscopic surgery on IA of TMJ upper compartment. METHODS: 142 patients (159 joints) with intraarticular adhesion confirmed by arthroscope were treated with lysis of adhesions, intraarticular clean-up operation or capsules radiofrequency catheter ablation. 110 patients (123 joints) accompanied with disc displacement underwent disc repositioning and suturing. The follow-up index included jaw movement, VAS pain value and patients' self-evaluation. The therapeutic effect was divided into excellent, good and poor, and excellent and good patients were defined effective. Jaw movement and VAS pain value before and after operation were evaluated by paired t test using SPSS11.0 software package. RESULTS: The average follow-up period was 10.3 months (2 to 27 months). 33.80% (48/142) of all joints was excellent; 56.34% (80/142) of all joints was good, and only 9.86%(14/142) was poor. The total effective rate was 90.14% (182/142). 93.66% (133/142) of all patients felt more comfortable than that of before operation. The interincisal opening increased from preoperative (23.14±5.93)mm (range from 10 to 40mm) to postoperative (37.48±3.51)mm (range from 30 to 40mm) (P<0.01), and the pain scores reduced from 28.94±23.54(0∼80) to 4.44±10.10(0∼40) (P<0.05). CONCLUSIONS: The effect of arthroscopic surgery on TMJ IA is affirmative. Surgery can increase the patients' mouth opening, improve jaw function and reduced pain in the jaw movement. [ABSTRACT FROM AUTHOR]

PURPOSE: To introduce a method to establish a rabbit model for temporomandibular joint (TMJ) intra-capsular adhesion. METHODS: The inferior and posterior walls of the right orbit in 16 rabbits were exposed. A needle, with suture, was passed vertically through the anterior part of the disc , which was tied with an elastic rubber loop. The elastic rubber loop was stretched anteriorly from 9.5mm to 40mm and fixed in a hole drilled in the zygomatic arch. The rabbits' TMJs were examined by MRI and endoscopy to assess the TMJID and intra-capsular adhesion respectively. Then, both TMJs and the surrounding tissues were excised en bloc and placed in neutral-buffered formalin for 36 hours. The demineralized specimens were embedded in paraffin and sectioned serially for examining under light microscopy stained with hematoxylin and eosin. RESULTS: The mandible of each operated rabbit deviated to the left side with inclined attribution of incisors. The disc was displaced forward and the degree of ADD among rabbits was uniform. CONCLUSION: The present study provides an advanced method for establishing model of anterior disc displacement of the temporomandibular joint. [ABSTRACT FROM AUTHOR]

In order to understand the status and characteristics of dental education in Europe, America and China, and clarify the shortcomings of dental education in China, this study selected Columbia University, Vienna Medical University and Shanghai Jiao Tong University College of Stomatology as representatives. The similarities and differences of the three institutions were compared through investigating education background and education model, in order to provide references for dental education. Supported by Medical Education Research Projects of Shanghai Jiao Tong University College of Stomatology(YB 120913). [ABSTRACT FROM AUTHOR]

Ranulas are mucoceles that develop as a result of mucous extravasation from the sublingual gland and typically present in the floor of mouth. The treatment of ranulas are various, mainly including surgical and nonsurgical methods. The preferred treatment of oral and plunging ranulas is still uncertain. According to the complications associated with surgical therapy, nonsurgical sclerotherapy has been advocated by clinicians for its advantages of less injury, no scar, less suffering, etc. Recently, it was reported that OK-432 was a relatively effective sclerosing agent for both lymphatic malformations and ranulas, although it has a high rate of recurrence after treating ranulas. Pingyangmycin is another reported conventional sclerosing agent for lymphatic malformations. Herein, we hypothesize that intracystic injection of pingyangmycin may be an optimal method for the treatment of ranulas. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of low intensity Nd: YAG laser and traditional drugs in the treatment of myofascial pain (MP)., Methods: Eighty patients with MP were divided into laser group(n=40) and traditional medicine group(n=40) according to the principle of randomization and double-blindness. The patients in the laser group were treated with low intensity Nd :YAG laser(1 064 nm, 8 J/cm 2 , 250 mW) , with an interval of 48 h between the two laser treatments. The whole course of treatment was 10 times. Patients in the traditional medicine group uesd celecoxib capsules, 1 capsulet each time(0.2 g), twice a day for 2 weeks. Before and after each treatment, mouth opening, protrusion excursion, lateral movement of the affected side and lateral movement of the contralateral side were measured, and pain visual analogue scores (VAS) were measured and recorded. The data were statistically analyzed with SPSS 22.0 software package., Results: Patients in laser group had significantly improved mandibular function and movement status(P＜0.05) and pain symptoms(P＜0.05); patients in traditional medicine group had the same significant improvement on mandibular functional movement status(P＜0.05) and pain symptoms (P＜0.05). The total effective rate of the two groups had no significant difference(P＞0.05). The VAS score of patients in laser group was lower than that of traditional medicine group, but the difference was not significant(P＞0.05)., Conclusions: Low intensity Nd: YAG laser and traditional medicine can effectively relieve the symptoms of myofascial pain and improve mandibular function and movement. Laser treatment has the advantages of short course of treatment, high efficiency, no pain and fewer side effects, which is worthy of clinical application.

Purpose: To explore the effect of bilateral coronoidectomy on stress distribution after reconstruction of temporomandibular joint (TMJ) by costochondral graft., Methods: Ten groups of models were established to simulate costochondral graft reconstruction with simultaneously different distances (0, 2, 4, 6, 8 mm) of mandibular advancement, with or without coronoidectomy. Force and stress distribution in the rib-cartilage area were analyzed by finite element analysis., Results: In the process of bilateral joint reconstruction with simultaneously mandible advancement ranging from 0 mm to 8 mm, when the coronoid processes were retained, the forward deformation of the cartilage occurred and the shear force decreased in turn, from 113.2 N to 26.7 N on the left side and from 133.7 N to 1.9 N on the right side. When the coronoid processes were removed, the cartilage deformed backward and the shear force increased successively, from 94.6 N to 188.5 N on the left and 70.1 N to 157.7 N on the right. The stress in the neck was obviously concentrated when mandible advanced 8 mm., Conclusions: Coronoidectomy has an important impact on stress distribution in the TMJ area, and keeping the coronoid process is beneficial to maintain the mechanical balance. Bilateral CCG reconstruction with coronoidectomy for lengthy mandible advancement (≥ 8 mm) may lead to prominent increase in shear force beyond CCG resistance, resulting in a costal-cartilage junction fracture.

Purpose: To compare the accuracy of implant placement between modified and traditional immediate implant placement in mandibular molar regions., Methods: Twenty-four patients were selected for immediate implantation in the molar area including 24 implantation sites. Preoperative cone-beam CT(CBCT) was conducted and then digital software Simplant 18.0 was used to design the ideal three-dimensional position of the implants. In the experimental group, the implant socket was prepared first according to reference of the remaining natural teeth, then the implant was implanted after minimally invasive extraction. Twelve patients in the control group underwent immediate implantation by traditional immediate implant procedures. Minimally invasive extraction, then socket preparation, and final implanting were performed. All patients underwent CBCT after surgery. Implant sites designed prior to surgery and actual implant sites differences between modified and traditional immediate implant placement were measured by Simplant 18.0 and compared with SPSS 17.0 software package., Results: In the experimental group and control group, the measured average deviation were as follows, the angle was (4.492±0.912)° and (7.255±1.307)°, respectively; The horizontal error of the implant shoulder was (0.379±0.083) mm and (1.229±0.270) mm, respectively; The measuring horizontal error of the implant apex was (1.263±0.267) mm and (2.183±0.264) mm, respectively; The calculative horizontal error of the implant apex was (1.324±0.203) mm and (2.709±0.383) mm, respectively; Depth error of the implant apex was (0.663±0.123) mm and (1.533±0.155) mm, respectively, which were significantly lower than those of the control group., Conclusions: Compared with the traditional method, modified immediate implantation can improve the accuracy of implantation in mandibular molars.

Purpose: To compare the mechanical properties of 3D-printed titanium meshes and pre-shaped titanium meshes, and to evaluate the effects of 3D-printed titanium meshes on cell proliferation and differentiation., Methods: 3D- printed titanium meshes were produced and prepared with laser printing machine. The mechanical properties were analyzed by static tension and compression load test. Bone marrow mesenchymal stem cells (BMSCs) were extracted from 4-week-old male SD rats. BMSCs were co-cultured with 3D-printed titanium meshes of different apertures. Cell counting kit-8 (CCK-8) assay was used to detect cell proliferation. Alkaline phosphatase (ALP) activity assay was used to test ALP activity. The expression of related osteogenic genes was tested by real-time PCR. The adhesion and growth of BMSCs were investigated by scanning electron microscopy (SEM) and living / dead cell staining. SPSS 22.0 software package was used for statistical analysis of the results., Results: The results of 3D-printing Ti-meshes tension and compression loading experiment were excellent. The 3D-printing Ti-meshes showed no inhibitory effects on cell proliferation, survival and adhesion, but had a positive effect on osteogenesis of BMSCs., Conclusions: The mechanical properties of 3D-printed Ti-meshes are excellent. The 3D-printed Ti-meshes have good biocompatibility.