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Treatment Approaches for Sinus Lift in the Presence of Maxillary Sinus Cyst LIU Zhonghao, ZHOU Wenjuan 2023, 39(4): 289-294.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.001 Abstract ( 286 )   PDF (8379KB) ( 455 )   As an evidence-based technique, maxillary sinus floor elevation can augment the available bone height for implant placement via elevating the sinus mucosa to provide bone regeneration space. This technique can be divided into lateral window technique and trans-crestal technique, which can be influenced by different risk factors such as membrane thickness, the sinus anatomy, and sinus lesions. Among all the risk factors, sinus mucosa cysts may increase the level of treatment difficulty and the surgery complications. The treatment option for such lesion during maxillary sinus floor elevation is still controversial, this paper summarized different treatment approaches to place implants in patients with sinus mucosa cysts when sinus floor elevation is needed. References | Related Articles | Metrics

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Advance in Effects of Deep Margin Elevation on Periodontal Tissue ZHANG Jingqiu, HE Shuqi 2023, 39(4): 295-299.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.002 Abstract ( 517 )   PDF (1328KB) ( 472 )   Subgingival dental defects are mainly caused by crown fracture and caries. Traditional restoration methods have poor prognosis due to many limitations. With the development of digital technology, adhesive materials, and the concept of minimally invasive restoration, deep margin elevation (DME), as a minimally invasive method for restoring subgingival tooth defects, has got more attention by prosthodontists for its high efficiency and convenience. To introduce the effect of DME on periodontal tissue, this review summarizes the research progress of material selection, postoperative marginal integrity, and biological width invasion. References | Related Articles | Metrics

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Study and Application of Vital Pulp Therapy in Mature Permanent Teeth LI Zeqi, LIU Qingmei 2023, 39(4): 300-303.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.003 Abstract ( 275 )   PDF (1593KB) ( 453 )   Maintaining vitality of the pulp is of great significance to the long-term preservation of mature permanent teeth. In recent years, supported by the studies of pulp biology, minimally invasive treatment of pulp and preservation of remaining healthy pulp have become the new target employed for mature permanent teeth with pulpitis. The primary aim of this review was to elaborate the research and application of vital pulp therapy (VPT) in mature permanent teeth in terms of classification, treatment, prognosis, and application of laser. References | Related Articles | Metrics

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Diagnosis and Biological Mechanism of External Cervical Resorption LI Wenwen, MA Wensheng 2023, 39(4): 304-307.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.004 Abstract ( 254 )   PDF (1010KB) ( 280 )   External cervical resorption is a special type of external root resorption that begins with the cervical of teeth, which is a pathologic phenomenon with a characterization of the hard tissue destruction due to the abnormal activities of odontoclasts. External cervical resorption is a complex and dynamic process that initially involves only periodontal ligaments, cementum, and dentin. In more advanced cases, the resorption lesion can affect the pulp tissue. Early lesions tend to appear latent, therefore they may be overlooked and not detected until symptoms appear at an advanced stage. This paper reviews the diagnosis and biological mechanism of external cervical resorption, and aims to provide a reference for the prevention and early blocking treatment of external cervical resorption. References | Related Articles | Metrics

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Prediction of Prognosis of HPV-negative Oral and Oropharyngeal Squamous Cell Carcinoma by Deep Learning Identification and Prediction Model of Cyclin D1 Expression Pattern YANG Ke, SUN Yanan, HU Yaying, LV Yinan, ZHEN Xiaofeng, LI Yiwei, ZHANG Jiali 2023, 39(4): 308-315.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.005 Abstract ( 193 )   PDF (3324KB) ( 161 )   Objective: To evaluate the relationship between the expression of cyclin D1 and the prognosis of patients with HPV-negative oral squamous cell carcinoma (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC), and to establish the image recognition scoring and survival prediction models based on cyclin D1 expression pattern. Methods: The clinicopathological data of 610 patients with HPV negative OSCC and OPSCC were analyzed retrospectively. The differences of overall survival (OS) rate and progression-free survival (PFS) rate of patients under different evaluation methods of cyclin D1 combining with p16/p53 expression and other factors were compared. The image recognition model to scoring cyclin D1 expression pattern was established by YOLOv5 algorithm. On this basis, the survival prediction model was established by DeepHit and DeepSurv algorithms, respectively. Results: There were three expression patterns of cyclin D1 in OSCC and OPSCC cancer nests. Superior to the expression level scoring method, the expression pattern scoring of cyclin D1 was significantly correlated with the prognosis of patients with OSCC (P<0.0001) and OPSCC (P<0.05). And it was an independent prognostic risk factor in both OSCC (P<0.0001) and OPSCC (P<0.05). Based on cyclin D1 expression pattern score model, the average accuracy of the test sets was (78.48±4.31)%. In OS prediction models established by DeepHit algorithm, the C-index of test set was 0.709±0.019, and in the models established by DeepSurv algorithm, the C-index of test set reached 0.715±0.029. Conclusion: Based on image recognition model of cyclin D1 expression pattern, the survival prediction model has a relatively good prediction effect on OS prognosis of HPV-negative OSCC and OPSCC. References | Related Articles | Metrics

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Effect of Silencing Long Noncoding RNA HOTAIR on Radiosensitivity of Tongue Squamous Cell Cells ZHANG Yang, GONG Zhongcheng, XIAO Xueling, LIU Pan, SU Weipeng, ZHAO Huarong 2023, 39(4): 316-321.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.006 Abstract ( 155 )   PDF (5552KB) ( 205 )   Objective: To investigate the effect of down-regulated expression of long-chain non-coding RNA HOTAIR on the radiosensitivity of tongue squamous cell lines CAL-27 and SCC-9. Methods: Three HOTAIR interference sequences were designed and transfected into tongue squamous cell cells CAL-27 and SCC-9 by lentiviral vector. The interference efficiency was verified by real-time fluorescence quantitative PCR (qRT-PCR). The cells were divided into blank group (CAL-27, SCC-9), experimental group (si-HOTAIR CAL-27, si-HOTAIR SCC-9), and negative control group (si-NC CAL-27, si-NC SCC-9). The cells were irradiated with 8Gy electron line. MTT assay was used to detect the cell proliferation, scratch assay was used to detect the cell migration, and flow cytometry was used to detect the cell apoptosis. Results: Among three lectin vectors, si-2 and si-3 down-regulated HOTAIR expression in tongue squamous cell cells CAL-27 and SCC-9 (P<0.05), and si-3 had the highest interference efficiency (P<0.05). After receiving 8Gy electron line irradiation, compared with the control group (si-NC CAL-27 and si-NC SCC-9), the proliferative ability of the experimental group (si-HOTAIR CAL-27 and SI-NC SCC-9) was significantly decreased (P<0.05), apoptosis rate was increased [(23.87±1.97) % vs. (46.03±2.49) %, (15.99±0.76) % vs. (39.38±2.95) %)], and migration rate was decreased [65.85% vs. 58.82%, 47.81% vs. 37.78%]. The difference was statistically significant (P<0.05). Conclusion: Reducing the expression level of HOTAIR can increase the radiosensitivity of CAL-27 and SCC-9 of tongue squamous cell. References | Related Articles | Metrics

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Application of Computer Navigation Technology in Radical Surgery for Advanced Malignant Tumors Involving Maxilla WU Zhuhao, ZHANG Xingwei, SUN Yawei, LI Zihui, CHEN Xin, PU Yumei, DONG Yingchun, SUN Guowen 2023, 39(4): 322-327.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.007 Abstract ( 144 )   PDF (4637KB) ( 202 )   Objective: To explore the application of computer navigation technology in the radical surgery of advanced malignant tumors involving the maxilla. Methods: Fifty-nine patients with advanced malignant tumors involving the maxilla who visited the First Ward of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital from January 2015 to January 2022 were selected and divided into the experimental group and the control group. The application value of computer navigation technology in surgery was analyzed retrospectively. Results: With the help of computer navigation technology, 59 patients successfully completed the surgery. The lesions were completely removed, and the removal scope was close to the skull base and reached the root of the wing plate, ensuring sufficient safe margins for deep surgery. In the experimental group, the average operation time was (6.29±2.76) hours, the average intraoperative bleeding volume was (803.67±321.18) mL, and the positive rate of the incision margin was (3.03±1.33)%. The average operation time of the control group was (7.49±1.50) hours, the average intraoperative bleeding volume was (931.03±337.44) mL, and the positive rate of the incision margin was (8.17±1.90)%. As of September 2022, the maximum survival time of 30 patients in the experimental group was 88 months, the minimum survival time was 5 months, and the average survival time was (36.42±22.35) months. The longest survival time of 29 patients in the control group was 87 months, the shortest survival time was 3 months, and the average survival time was (31.49±24.08) months. One patient in the experimental group needed nasal feeding, and three patients in the control group needed nasal feeding. Conclusion: The computer navigation technology can help surgeons better protect the important anatomical structures of the skull base, better control the safe surgical margin of the posterior deep part of the maxilla, and increase the surgical safety. It has a certain significance in determining the surgical thoroughness of patients with advanced malignant tumors involving the maxilla. References | Related Articles | Metrics

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Anatomy of Medial Sural Artery Perforator Flap and Its Application in Repairing Oropharyngeal Defects after Operation LUO Lei, ZHU Jin, WANG Weihong, XIA Bin, LIU Yu, SHI Yan'an, QIAN Yemei, LI Jingyi 2023, 39(4): 328-331.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.008 Abstract ( 154 )   PDF (3772KB) ( 152 )   Objective: To investigate the clinical application of medial sural artery perforator flap in repairing postoperative defects of oropharyngeal malignant tumors. Methods: The main blood supply vessels and perforating branches were dissected by simulated operation on the sural muscle region of 5 specific cadavers, and the anatomical images were analyzed by Image-Pro Plus6.0 software. From September 2020 to September 2022, 8 cases of oropharyngeal malignant tumors were repaired with medial gastrocnemius artery perforator flaps. Results: The mean vascular pedicle length of the medial sural artery perforator flap was (10.82±0.89) cm, and the mean vascular diameter of the starting end of the medial sural artery was (3.13±0.31) mm. A total of 8 patients with oropharyngeal malignant tumors were repaired with medial sural artery perforator flaps. All flaps survived completely, and there were no obvious postoperative complications at the donor site. Conclusion: The medial sural artery perforator flap is a good choice for repairing the defect after oropharyngeal malignant tumor surgery with long pedicle, suitable diameter, and no obvious complications in donor site. References | Related Articles | Metrics

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Incidence of Implant Fracture and Related Risk Factors ZHANG Yanjing, XU Jialin, ZHU Huilin, ZHOU Hong 2023, 39(4): 332-335.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.009 Abstract ( 188 )   PDF (1569KB) ( 225 )   Objective: To analyze the cause of implant fracture after different periods of load, evaluate the risk factors, and explore the clinical strategies to prevent implant fracture. Methods: A total of 2492 patients(with 4823 implants)treated in the Department of Oral Implantology, the First Affiliated Hospital of Zhengzhou University from July 2009 to December 2020 were included. The patients' medical records and the X-ray films were used to analysis the risk factors affecting implant fracture and discuss the preventive measures. Results: Eight patients with 9 implants were found to occur the implant fractures. The average loading time of the implants was (7.2±3.19) years, the age of the patients at the time of implant fracture was (55.5±11.13) years, the incidence of implant fracture during follow-up was 0.18% (9/4823). Conclusion: The clinical symptoms before implant fracture can predict implant fracture. If the clinical symptoms are observed, appropriate clinical treatment should be taken in time. Implant diameter, repair method, patient's parafunctions were the influencing factors of implant fracture. References | Related Articles | Metrics

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Effect of Immediate Loading on Edentulous Space Maintenance of Non-free End Single Tooth in Mandibular Posterior Area WANG Yuzhuo, LI Gan, LI Xiaofei, WEI Luming, WANG Jing, WANG Penglai 2023, 39(4): 336-340.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.010 Abstract ( 134 )   PDF (2857KB) ( 112 )   Objective: To investigate the effect of immediate loading on the three-dimensional space after the loss of non-free end of single tooth in mandibular posterior area. Methods: Forty patients who received single dental implant at the non-free end of the mandibular posterior region were included in the study. The experimental group (n=20) received immediate loading therapy with routine implantation, and the control group (n=20) received conventional loading therapy with routine implantation. The intraoral optical scanning data were collected on the same day and 3 months after surgery, and then the three-dimensional position changes of adjacent teeth and jaw teeth were analyzed by three-dimensional registration and deviation analysis algorithm, and their mean deviation (AVG) and root mean square (RMS) were recorded. Results: The AVG and RMS of mesial and distal changes of the mesial adjacent teeth in the experimental group were (20.83±9.07) μm and 25.66±10.82, respectively, which were smaller than those in the control group. AVG=(106.38±38.41) μm, RMS=118.74±42.18. The AVG and RMS of mesial and distal changes of the distal adjacent teeth in the experimental group were (12.03±8.01) μm and 14.59±8.95, respectively, which were smaller than those in the control group. AVG=(113.63±42.79) μm, RMS=127.39±45.93, and the difference was statistically significant. The AVG and RMS of vertical change of the antagonist teeth in the experimental group were (19.66±8.59) μm and 23.97±9.93, respectively, which were lower than those in the control group. AVG=(61.38±18.29) μm, RMS=70.54±21.42, and the difference was statistically significant. Conclusion: The edentulous space can be effectively maintained by the conventional planning with immediate loading treatment after the loss of the non-free end of the single tooth in the mandibular posterior area. References | Related Articles | Metrics

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Stress Analysis of Periodontal Membrane in Distal Maxillary Dentition JIANG Xiaoyu, ZHU Jiejing, WANG Dongcai, REN Yanyun 2023, 39(4): 341-344.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.011 Abstract ( 179 )   PDF (3610KB) ( 202 )   Objective: To investigate the distribution of periodontal stress and the risk area of root resorption in the maxillary whole dentition with different loading modes by using three-dimensional finite element technique. Methods: Three dimensional finite element models including maxilla, upper dentition, and periodontal membrane were established. The periodontal stress of each tooth in the maxillary dentition was recorded and analyzed by controlling different traction directions (a total of 12 groups). Results: The traction hook height was 0 mm, implant position located between lateral incisors and canines or between canines and first premolars, and the micro-implant length was 0 mm or 7 mm were relatively uniform in the 12 groups. The periodontal stress of each tooth was within a moderate range, and the efficiency of the dentition moving in the sagittal direction was high. Conclusion: When the traction force is parallel to the arch wire (23-0-0, 34-0-0), the force system is relatively uniform, the periodontal membrane of each tooth is subjected to a moderate range of stress, and the efficiency of the dentition moving in the sagittal direction is high. The molars area is not prone to excessive pressure, while the anterior teeth area is prone to excessive pressure, which may be related to the anatomy and location. The tooth near the hook is a risk area for root resorption. It is not recommended to use the high micro-implant and high traction hook together, and pay attention to the vertical force on the lateral incisors and canines. References | Related Articles | Metrics

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Comparison of Clear Aligners under Different Anterior Lip Inclines and Adduction Compression Steps: A Three-dimensional Finite Element Study KANG Fujia, WU Yumiao, LIU Xinyu, YU Lei, LI Xinyi, ZHANG Haoyan, ZHU Xianchun 2023, 39(4): 345-349.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.012 Abstract ( 221 )   PDF (1903KB) ( 222 )   Objective: To investigate the tooth movement characteristics in the treatment of different anterior tooth lip inclination and different adduction movement step with the clear gligner by finite element analysis. Methods: The finite element model of maxillary anterior adduction with the step method of clear aligner was established. According to the lip inclination of central incisor and lateral incisor, it was divided into working condition 1: U1-SN=105°, working condition 2: U1-SN=115°, and working condition 3: U1-SN=125°. The total step distance of tooth movement was 0.2 mm, including the adduction along the occlusion plane and the compression along the long axis of the tooth body. The internal adduction a: 0.18 mm, b: 0.14 mm, c: 0.10 mm in each group of working conditions were divided into groups to analyze the tooth movement characteristics under the above different conditions. Results: Under different anterior lip inclination and adduction modes, the crown of the central incisor and lateral incisor were inclined to move to the lingual side and the root to the labial side, while the crown of the second premolar to the second molars was inclined to move to the proximal center. The greater the adduction step distance, the greater the lingual displacement of the anterior tooth crown, the greater the torque change of the anterior tooth, and the greater the mesial movement of the crown from the second premolar to the second molar. Conclusion: When the anterior teeth are adducted by the invisible orthodontic device without bracket, the lingual inclination and elongation of the anterior teeth and the mesial inclination of the posterior teeth are caused by the displacement of the anterior teeth, which is proportional to the distance of the adduction step. The pre-designed absolute compression of the anterior teeth cannot offset the relative elongation caused by the tooth adduction. References | Related Articles | Metrics

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Effect of Age-related Factors on Pain after Initial Adhesion in Patients with Fixed Appliance GU Ming, XU Hui 2023, 39(4): 350-352.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.013 Abstract ( 163 )   PDF (783KB) ( 171 )   Objective: To explore the influence of age on the pain level of orthodontic patients after initial bracket wearing. Methods: A total of 18 adolescents (11-14 years old) and 18 adults (18-25 years old) with straight wire appliance were enrolled in this study. Visual analog scale (VAS) was used to evaluate the effect of age on orthodontic pain at 7 different time points after the first bracket bonding (immediately, 4 h, 12 h, 1 d, 2 d, 3 d, and 7 d). Results: The time effect was significant (F=94.294,P＜0.01), the main effect of age was not significant (P>0.05), and the interaction effect of age and time was significant (F=54.114,P＜0.01). The age-related effects were significant at 4 h, 2 d, and 3 d after the first loading (P<0.01 at 4 h, P<0.05 at 2 d, and P<0.01 at 3 d). Conclusion: Adolescent patients with fixed appliances respond quickly and sensitively to mechanical force, while adult patients respond slowly but more persistently to inflammatory pain after mechanical force. References | Related Articles | Metrics

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Effect of Gingival Biotype on Periodontium of Maxillary Impacted Canine after Orthodontic Traction CHU Kejia, WANG Haihui, ZHENG Zhijun, PENG Juxiang 2023, 39(4): 353-356.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.014 Abstract ( 170 )   PDF (1639KB) ( 156 )   Objective: To study the influence of different gingival biotypes on periodontal tissue of maxillary impacted canines after orthodontic traction. Methods: Twenty-four patients with unilateral impacted canines were divided into thin gingival biotype group and thick gingival biotype group (n=12 for each group) according to the gingival thickness of the contralateral canine. After treatment, the apical alveolar bone thickness, labial alveolar bone thickness, the loss of labial alveolar bone height, and gingival attachment width of impacted canines and control canines were measured. Results: The differences of any measurement variables between two groups were significant after the treatment (P<0.05). The differences of the labial alveolar bone thickness, the loss of labial alveolar bone height, and gingival attachment width between the impacted canines and the control canines in the thick gingival biotype group were smaller than those in the thin gingival biotype group (P<0.05). Conclusion: The thick gingival biotype is more beneficial to the reconstruction of periodontium for maxillary impacted canine after orthodontic traction. References | Related Articles | Metrics

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Clinical Effect of Endodontics for Acute Pulpitis in Early Pregnancy SUN Qiong, JIANG Xiaomin, SHEN Zhengyan, LI Peng, CAI Yinyin 2023, 39(4): 357-361.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.015 Abstract ( 195 )   PDF (1311KB) ( 248 )   Objective: To explore a safe and effective treatment for acute pulpitis in early pregnancy. Methods: Twenty-nine patients (29 teeth) with acute pulpitis diagnosed in the early pregnancy were treated with oral hygiene instruction before operation to relieve their anxiety. The access and coronal cavity preparation was performed under Single Tooth Anesthesia System. ApexCal paste was placed with temporary glass ionomer sealers after cleaning and shaping the root canal system. Root canal obturation was completed 2-3 months after delivery. The VAS pain rating scale before and 48 hours after the operation, the condition of teeth during the drug sealing period, and the pregnancy outcome and newborn condition (Apgar rating scale) were recorded. Follow-up was performed 12 months after root canal therapy. Results: There was a significant difference in VAS pain scores before and 48 hours after operation (P<0.001). After root canal preparation, 28 cases had effective pain relief and safely passed the pregnancy period. The effective rate was 96.6%. After 12 months of reexamination, 27 cases were finally treated successfully, with a success rate of 93.1%. All patients did not have adverse pregnancy outcomes, such as abortion, and Apgar scoring scale assessed normal newborns. Conclusion: The patients with acute pulpitis in early pregnancy can delay the completion of root canal obturation with painless, aseptic, and minimally invasive operation on the premise of eliminating anxiety, which is safe and effective. References | Related Articles | Metrics

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Effect of Liquid Phase Concentrated Growth Factor Combined with Hyaluronic Acid Injection on Temporomandibular Joint Osteoarthritis ZHAO Chen, JIANG Shanshan, LIU Yang, WU Suran, QIU Tong, BAI Yuehui, WU Jie, JIA Yujing 2023, 39(4): 362-369.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.016 Abstract ( 156 )   PDF (9315KB) ( 115 )   Objective: To investigate the effect of autologous liquid phase concentrated growth factor (LPCGF) combined with hyaluronic acid (HA) injection in the treatment of rat temporomandibular joint osteoarthritis (TMJOA). Methods: A total of 33 SD rats were used in the present study, including blank control group (n=3) and experimental group (n=30). Type Ⅱ collagenase was injected into bilateral TMJ cavity to establish TMJOA model. Three rats were randomly selected as the untreated group from experimental group, while the rest of experimental group was selected as treated group and was randomly divided into three subgroups, including HA group (A), LPCGF group (B), and combined treatment group (C). Each group was treated with intra-articular injection once a week, and the tissue samples of TMJ were acquired from three rats randomly every week for 2, 4, and 6 weeks after treatment. HE staining and Safranin O-fast green staining were performed to observe histological changes of the joints and evaluate according to the modified Mankin's score. Immunohistochemistry was performed to detect the changes of interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) in condylar cartilage. Results: Intra-articular injection of type II collagenase could successfully induce the rat TMJOA model. Histological observation revealed the repair of condylar cartilage and subchondral bone after injection treatment. The modified Mankin’s score was reduced in all treated groups (P>0.05). The immunohistochemical results showed that the expression of IL-1β and TNF-α in TMJ cartilage could be significantly inhibited by HA or LPCGF injection treatment, and the combined treatment group had the most significant inhibition effect (P<0.05). Conclusion: Both LPCGF and HA can treat temporomandibular joint osteoarthritis in rats. However, LPCGF combined with HA injection has the most significant effect on the modification of condylar and inhibition of IL-1 and TNF-α in articular cartilage (P<0.05). References | Related Articles | Metrics

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Diffuse Sclerosing Osteomyelitis of the Mandible:A Case Report FU Shuai, PENG Canbang, WANG Lidong, MA Wen, LI Yanxi, LI Ming, WU Yong 2023, 39(4): 370-372.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.017 Abstract ( 262 )   PDF (3410KB) ( 340 )   Diffuse sclerosing osteomyelitis (DSO) is a rare disease with unknown etiology, which is poorly understood by clinicians and often misdiagnosed. This article reported a case of DSO of the mandible. The related literatures were reviewed in order to improve the recognition of the diseases. References | Related Articles | Metrics

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Minimally Invasive Extraction of Mesiodens by Punching Out: A Case Report WANG Jiaqing, MA Xiaowei, LI Hongwei 2023, 39(4): 373-374.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.018 Abstract ( 241 )   PDF (1852KB) ( 377 )   The extraction of supernumerary teeth should follow the minimally invasive principle to avoid adverse effects on the development of permanent teeth and jaws in children and adolescents. Traditional operations have large trauma and many complications. This paper reported a case of maxillary embedded mesiodens that was impacted in the sagittal direction between the roots of bilateral central incisors and was extracted as a whole by punching out method. The minimally invasive surgery of no flap or bone removal was achieved. References | Related Articles | Metrics

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Complete Denture Rehabilitation for Patient with A Free Fibula Flap after Segmental Mandibulectomy: A Case Report LIU Chun, WANG Jingwen, ZHAO Rui, ZHAO Xinxin, ZHAO Yi 2023, 39(4): 375-377.  DOI: 10.13701/j.cnki.kqyxyj.2023.04.019 Abstract ( 183 )   PDF (3047KB) ( 218 )   After reconstruction of mandibular defects with vascularized free bone graft, the prosthetic restoration is challenging due to the less height of the reconstructed mandible, absence of attached gingiva, vestibular groove, and mandibular-lingual groove. This paper reports a case of an adjusted complete denture rehabilitation of the edentulous jaw with fibula reconstruction of segmental mandibulectomy due to medcation-related osteonecrosis, with better results of mastication, esthetics, and function. References | Related Articles | Metrics