Stafne bone cavity, also known as static bone cavity, is a rare bony defect on the lingual side of the mandible. It rarely shows progressive changes, and requires only follow-up bservation. This article described a case of progressive enlargement of a Stafne bone cavity and analyzed the causes of its progress by reviewing relevant literature.
Biological hydroxyapatite (BHA) is widely used in the treatment of clinical bone defects due to its good biocompatibility and osteoconductivity. The clinical application of mateiral size is based on the principle of bone defect area adaptation, which contributes to diversity of BHA sizes. However, different sizes correspond to different hierarchical levels of bone biomimicry. As the size changes, the bone biomimicry hierarchy evolves accordingly and influences the process of bone repair and regeneration through osteo-coagulo-immunomodulation, leading to unstable bone graft outcomes. Therefore, this paper reviews the size effect of clinical BHA, analyzes the multilevel structure of natural bone, proposes the evolution of bone biomimetic hierarchy triggered by the size of BHA, and further analyzes the size-media-ted osteo-coagulo-immunomodulation. Based on the hierarchical levels of bone and its osteo-coagulo-immunomodulation effect, we provide a new understanding of the biological principle of the size effect of biomaterials and a theoretical basis for the basic research and clinical application of different size BHA materials.
Objectives: The effect of metal precrown restoration of distal proximal maxillofacial caries in the first deciduous molar on the composite resin filling of mesio-adjacent maxillofacial caries in the second deciduous molar was investigated.
Methods: A total of 80 children aged 4-8 who visited our clinic were selected, and 120 teeth were examined. Two consecutive deciduous molars in one jaw were considered a single case when the distal proximal maxillary surface of the first deciduous molar and the mesial proximal maxillary surface of the second deciduous molar simultaneously had caries. The teeth were randomly divided into two groups: group A (68 cases), in which the first and second molars were repaired with composite resin, and group B (52 cases), in which the first deciduous molar was repaired with metal precrown after composite resin filling and the second deciduous molar was filled with composite resin. The two groups were compared in terms of the success rate of composite resin filling in the second deciduous molar.
Results: At 3 months, no significant difference (P>0.05) was found between groups A (92.65%) and B (96.15%). At 6 months, no significant difference (P>0.05) was observed between groups A (89.71%) and B (94.23%). At 12 months, statistically significant difference (P<0.05) was found between groups A (73.53%) and B (88.46%); At 24 months, statistically significant difference (P<0.05) was found between groups A (66.18%) and B (86.54%).
Conclusions: Compared with composite resin filling of the first deciduous molar, the metal precrown restoration of the first deciduous molar can improve the success rate of composite resin filling of the second deciduous molar.
Objectives: This study aimed to explore the risk factors of postoperative hypokalemia in patients with oral cancer and to provide a basis for preventing and controlling postoperative hypokalemia.
Methods: We included 366 patients undergoing oral cancer surgery in the Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University from January 2022 to August 2022. Univariate and multivariate analyses were used to determine the risk factors of postoperative hypokalemia. The receiver operation characteristic (ROC) curve was used to quantify the effectiveness of the factors. A nomogram of the risk factors for postoperative hypokalemia in oral cancer patients was developed and validated.
Results: A total of 224 patients (61.20%) had postoperative hypokalemia, the lowest serum potassium level (3.50±0.35) mmol/L on the 4th day after surgery, and the highest incidence of hypokalemia (54.68%). Variables with P<0.05 in the univariate analysis were quantified by ROC curve followed by multivariate logistic regression analysis. Results showed an independent correlation with postoperative hypokalemia as follows: preoperative serum potassium<3.87 mmol/L (P=0.008), preoperative serum calcium<2.31 mmol/L (P=0.033), preoperative PNI<49.16 (P=0.032), postoperative drainage volume>264.25 mL (P=0.002). The above variables were constructed into a postoperative hypokalemia risk nomogram and verified, and a good degree of fit was found.
Conclusions: The independent risk factors for postoperative hypokalemia in patients with oral cancer were as follows: preoperative serum potassium<3.87 mmol/L, preoperative serum calcium<2.31 mmol/L, preoperative PNI<49.16, and postoperative drainage volume>264.25 mL. Clinical attention should be paid to managing the above high-risk patients. Preventive potassium supplementation should be performed as soon as possible to reduce hypokalemia occurrence.
Objectives: This study aims to investigate the role of genes related to fatty acid metabolism in periodontitis through machine learning and bioinformatics methods.
Methods: Periodontitis datasets GSE10334 and GSE-16134 were downloaded from the GEO database, and the fatty acid metabolism-related gene sets were obtained from the GeneCards database. Differentially expressed fatty acid metabolism-related genes (DEFAMRGs) in periodontitis were screened using the "limma" R package. Functional enrichment and pathway analyses were conducted. Recursive Feature Elimination, Least Absolute Shrinkage and Selection Operator, and Boruta algorithm were used to determine hub DEFAMRGs and construct diagnostic models with internal and external validation. Subtypes of periodontitis related to hub DEFAMRGs were constructed using consistency clustering analysis. CIBERSORT was used to analyze immune cell infiltration in gingival tissues and explore the correlation between hub DEFAMRGs and immune cells.
Results: A total of 113 periodontitis DEFAMRGs were screened out as a result. The enrichment analysis results indicate that DEFAMRGs are mainly associated with immune inflammatory responses and immune cell chemotaxis.Finally, 8 hub DEFAMRGs (BTG2, CXCL12, FABP4, CLDN10, PPBP, RGS1, LGALSL, and RIF1) were identified and a diagnostic model (AUC=0.967) was constructed, based on which periodontitis was divided into two subtypes. In addition, there is a significant correlation between hub DEFAMRGs and different immune cell populations, with mast cells and dendritic cells showing higher correlation.
Conclusions: This study provides new insights and ideas for the occurrence and development mechanism of periodontitis and proposes a diagnostic model based on hub DEFAMRGs to provide new directions for diagnosis and treatment.
Objectives: This study aimed to compare the impacts of undertaking symmetrical bone repair of the nasal alar base combined with nasolabial deformity repair versus nasolabial deformity repair alone on the improvement in nasal deformity of patients with unilateral cleft lip and alveolar cleft.
Methods: Fifty patients presenting with unilateral cleft lip and alveolar cleft were evaluated. Among them, 20 underwent nasolabial deformity repair solely (non-bone grafting group), whereas 30 patients received bone repair in conjunction with nasolabial deformity repair (bone-repair group). Preoperative measurements and one-year follow-up results were assessed through photographic anthropometric analysis. According to the Farkas anthropometric standard, the nasal anatomic landmarks were located, and 10 nostril indicators were measured. The operative effects of two groups were compared.
Results: In contrast to the non-bone-grafting group, the nasal deformity of patients in the bone-repair group demonstrated significant improvement one year post-operation. The symmetry parameters of the nasal columella more closely approximated 1, the columella deviation angle more closely approached 90°, and the sub-alare inclination angle and the inclination angle of the nasal alar were smaller (P<0.05).
Conclusions: The accomplishment of symmetrical bone repair of the nasal alar base is conducive to enhancing nasal deformity after cleft-lip surgery in patients with unilateral cleft lip and alveolar cleft. This strategy has a positive influence on nasal symmetry, the morphology of the nasal alar, and nasal base deformity.
GLI1-altered mesenchymal tumors are a relatively rare type of mesenchymal tumor that is common in the head and neck. It is a newly added tumor type in the World Health Organization Tumor Classification of Head and Neck (5th edition). This article reports a case ofGLI1-alteredmesenchymal tumor occurring at the left tongue and reviews the relevant literature to summarize the pathological morphological characteristics, immunophenotype, molecular changes, clinical manifestations, and prognosis of the disease.
Objectives: This paper aims to construct a system integrating mixed reality technology with artificial algorithm and to evaluate its effectiveness in vascular localization during anterolateral thigh perforator flap surgery to provide new insights for clinical practice.
Methods: Twenty patients undergoing anterolateral thigh perforator flap repair were selected. After attaching positioning devices on the lower limb, CT angiography (CTA) scans were performed. The 2D data obtained were converted into a 3D model of the positioning device and vessels. Mixed reality technology was utilized to achieve 3D visualization of perforator vessels. An artificial algorithm was developed in HoloLens 2 to match the positioning device automatically with its 3D model intraoperatively to overlap the perforator vessels with their 3D models. The number of perforator vessels identified within the flap harvesting area and the actual number detected during surgery were recorded to calculate the accuracy rate of vessel identification based on CTA data reconstruction. The distance between the perforator vessel exit points located by the system and the actual exit points was measured, and the error values were calculated. The surgical time required for the system to harvest the anterolateral thigh perforator flap was documented and compared with the surgical time required by conventional methods. The clinical applicability of the system was discussed.
Results: The CTA data reconstruction identified 30 perforator vessels, while the actual number found during surgery was 32, resulting in an identification accuracy rate of 93.75%. The average distance between the perforator vessel exit points located by the system and the actual exit points was (1.65±0.52) mm. The average surgical time for flap harvesting with the assistance of the system was (43.45±4.6) min compared with (57.6±7.9) min required by conventional methods. All perforator flaps survived the procedure. One case of flap infection occurred seven days postoperatively, and one case of partial flap necrosis was treated with symptomatic therapy, resulting in delayed healing.
Conclusions: The system constructed in this paper can achieve 3D visualization of perforator vessels through mixed reality technology and improve the accuracy of perforator vessel localization using artificial algorithms, hence demonstrating potential application in anterolateral thigh perforator flap harvesting surgeries.
Objectives: This paper aims to explore the application value of mixed reality in oral and maxillofacial surgery and to conduct dynamic tracking using an in vitro model.
Methods: By collecting preoperative enhanced CT data of patients, rebuilding 3D digital model, combined with 3D printing technology, dynamic tracking of lesions was realized in the in vitro model, and the efficiency of different registration methods was compared.
Results: The 3D visualized head and neck model was obtained by combining multiple anatomical models, and dynamic tracking was completed in vitro. The average tracking time of the facial mark recognition method was T45°=3.67 frames, T90°=10.67 frames, and T total=12 seconds 28 frames (30 frames per second). The average tracking time of QR code recognition method was T45°=1.67 frames, T90°=2.33 frames, and T total=11 seconds 13 frames (30 frames per second).
Conclusions: The combination of MR technology and 3D printing technology can realize the dynamic tracking of lesions in vitro, which lays a foundation for the clinical application of MR technology to implement precise, personalized surgical programs.
Objectives: This study aims to compare and analyze three types of generative artificial intelligence (GAI) and explore their application value and existing problems in the field of stomatology in the Chinese context.
Methods: A total of 36 questions were designed, covering all the professional areas of stomatology. The questions encompassed various aspects including medical records, professional knowledge, and translation and editing. These questions were submitted to ChatGPT4-turbo, Gemini (2024.2) and ERNIE Bot 4.0. After obtaining the answers, a blinded evaluation was conducted by three experienced oral medicine physicians using a four-point Likert scale. The value of GAI in various application scenarios was evaluated.
Results: Gemini scored 45, ERNIE Bot scored 38, and ChatGPT scored 33 for clinical documentation and image production. For research assistance, Gemini achieved 45, ERNIE Bot had 39, and ChatGPT scored 35. Teaching assistance capabilities were rated at 54 for ERNIE Bot, 50 for Gemini, and 48 for ChatGPT. In patient consultation and guidance, Gemini scored 78, ERNIE Bot scored 59, and ChatGPT scored 48. Overall, the total scores were 218, 190, and 164 for Gemini, ERNIE Bot, and ChatGPT, respectively. Among GAI applications, the top scoring categories were article translation and polishing (26), patient-doctor communication documentation (23), and popular science content creation (23). The lowest scoring categories were literature search and reporting (13) and image generation (12).
Conclusions: In the Chinese context, the application value of GAI is the highest for Gemini, followed by ERNIE Bot and ChatGPT. GAI shows significant value in translation, patient-doctor communication, and popular science writing. However, its value in literature search, reporting, and image generation remains limited.
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