Evaluation of Postoperative Psychological Distress and Its Driving Factors in Patients with Oral and Maxillofacial Malignant Tumors

Objective:To explore and analyze the evaluation and driving factors of postoperative psychological pain inpatients with oral and maxillofacial malignant tumors.Methods:Relevant data were collected from 80 patients with oral and maxillofacial malignant tumors who attended the outpatient clinic for follow-up consultations between May 2021 to May 2023.The patients used the psychological distress thermometer(DT)to circle words that best described their experiences in the past week,assigning a numerical value(0-10)to indicate their pain level on each day.The scoring results were employed to assess the psychological pain in these patients.A self-developed patient basic information questionnaire was utilized to record demographic details.Logistic regression analysis was employed to evaluate patients two weeks after surgery,focusing on the assessment of psychological distress and the identification and location of driving factors.Results:Following evaluation,the results revealed that the average postoperative DT score for the 80 patients with oral and maxillofacial malignant tumors was 4.53±1.98 points.Scores<4 points indicated no psychological pain(Group N)in 48 cases,while scores≥4 points indicated psychological pain(Group Y)in 32 cases.The differences in postoperative DT scores among patients with varying educational levels,fears and worries about disease progression,economic problems,sleep problems,level of hope,and oral pain were statistically significant(P<0.05).Multiple linear regression analysis results indicated that education level,fear and worry about disease progression,economic problems,sleep problems,level of hope,and oral pain are driving factors of postoperative psychological pain in patients with oral and maxillofacial malignant tumors(P<0.05).Conclusion:The postoperative psychological pain level in patients with oral and maxillofacial malignant tumors is at a moderate level.Educational level,fear and worry about disease progression,economic problems,sleep problems,level of hope,and oral pain were identified as driving factors for postoperative psychological pain in these patients.

Oral and maxillofacial pain as the first sign of metastasis of an occult primary tumour:A fifteen-year retrospective study

BACKGROUND Metastatic adenocarcinoma of the jaw(MAJ)is a rare disease that accounts for 1%-3%of all oral and maxillofacial malignant tumours.Oral and maxillofacial pain may be the first symptom of metastatic spread of an occult primary tumour.Therefore,early identification of oral and maxillofacial pain by dental professionals is critical.AIM To explore the clinical and computerized tomography(CT)features of MAJ with oral and maxillofacial pain as the first symptom.METHODS The medical records of all patients who were treated in our hospital between January 2006 and February 2020,and diagnosed with MAJ with oral and maxillofacial pain as the first symptom,were reviewed retrospectively.Clinical data were collected on age,sex,medical history,clinical manifestations,site of metastasis,and site of the primary lesion.CT features were analysed in detail,and a radiological classification scheme comprising five types:Osteolytic,osteoblastic,mixed,cystic,and alveolar bone resorption was proposed.RESULTS The primary sites of MAJ were the lungs(n=6),liver(n=4),kidneys(n=2),prostate(n=1),and gastric cardia(n=1).Five tumours were classified as the osteolytic type,all with a permeative margin(100%,P<0.05),and three were classified as the mixed type,mostly with a moth-eaten margin(80%,P<0.05).The cystic(n=3)and alveolar bone resorption(n=1)types had geographic margins,and the osteoblastic type(n=1)had sclerotic margins.Moreover,nine tumours showed periosteal reaction and five showed a localised soft tissue mass,while the occurrence of jaw expansion was relatively rare.CONCLUSION MAJ has complex clinical and CT features.Oral and maxillofacial pain may be the first sign of a primary tumour affecting other sites.

The erapeutic effect of triamcinolone acetonide with pingyangmycin on lymphatic malformations in oral and maxillofacial regions

Objective To investigate therapeutic effect of tri- amcinolone acetonide and pingyangmycin on lymphatic malformations in oral and maxillofacial regions. Methods 29 patients with lymphatic malformations in oral and maxillofacial regions were divided into two groups to re-

Wet-adhesive materials of oral and maxillofacial region:From design to application

Oral and maxillofacial diseases are a group of high-incidence disorders that affect people’s life quality to a great extent,while the wet and highly movable environment of the related regions brings challenges to traditional therapies.Faced with the obstacles of insufficient adhesive strength and ensuing short drug retention time,conventional oral therapeutic agents often have difficulty in achieving their desired efficacy.Oral and maxillofacial wet-adhesive materials have the advantages of excellent wet environment retention,internal stability,plasticity,and clinical potential,thus have become a significant research direction in the field of oral related disorders healing.In the past decade,the development of oral adhesive materials with good wet adhesion has accelerated based on the chemical molecular interaction,physical interlocking,and biological adhesion mechanisms,including biomimetic-inspired materials,naturally derived polymer–based materials and adhesive electrospun fiber films.These fancy wet-adhesive materials can be used for oral mucosal drug delivery,oral vaccination,wound healing,and bone defects treatments.Despite their numerous novel applications,wet-adhesive materials in stomatology still face unresolved challenges from material and biological aspects.Here,advances in designs of oral and maxillofacial wetadhesive materials are reviewed in terms of design backgrounds,attachment mechanisms,and common classifications.Recent demonstrations of wet-adhesive materials for oral and maxillofacial region medical applications from drug delivery to multifunctional tissue treatments are presented.To conclude,current challenges and prospects on potential applications of oral and maxillofacial wet-adhesive materials are also briefly discussed.

Combined and sequential treatment of oral and maxillofacial malignancies： an evolving concept and clinical protocol

Objective To introduce the concept and rational regimens and present the latest development of combined treatment of oral and maxillofacial malignancies. Data sources The related published literature was searched through the CNKI database and MEDLINE using the terms of oral cancer, oral and maxillofacial malignancies, combined and sequential therapy, multidisciplinary approach. Study selection The available related literature was read and evaluated. Studies that met the inclusion criteria were selected. Results The results show that oral and maxillofacial malignancies diagnosed at an early stages （stages Ⅰ and Ⅱ） can be well treated with surgery alone and/or radiotherapy with optimal outcome, but advanced or recurrent diseases should be treated with rational combined and sequential treatment modalities. The use of concomitant chemoradiotherapy, taxane-containing, three-drug induction regimens and Cetuximab in combination with chemotherapy or radiotherapy demonstrated favorable results in previously untreated patients with head and neck squamous cell carcinoma. Conclusions The concept of combined and sequential treatment of advanced oral and maxillofacial malignancies should be widely accepted, and the rational regimen for individual and each type of entity should be determined based on the anatomical site and the patient＇s performance status.

Research status of biodegradable metals designed for oral and maxillofacial applications:A review

The oral and maxillofacial regions have complex anatomical structures and different tissue types,which have vital health and aesthetic functions.Biodegradable metals(BMs)is a promising bioactive materials to treat oral and maxillofacial diseases.This review summarizes the research status and future research directions of BMs for oral and maxillofacial applications.Mg-based BMs and Zn-based BMs for bone fracture fixation systems,and guided bone regeneration(GBR)membranes,are discussed in detail.Zn-based BMs with a moderate degradation rate and superior mechanical properties for GBR membranes show great potential for clinical translation.Fe-based BMs have a relatively low degradation rate and insoluble degradation products,which greatly limit their application and clinical translation.Furthermore,we proposed potential future research directions for BMs in the oral and maxillofacial regions,including 3D printed BM bone scaffolds,surface modification for BMs GBR membranes,and BMs containing hydrogels for cartilage regeneration,soft tissue regeneration,and nerve regeneration.Taken together,the progress made in the development of BMs in oral and maxillofacial regions has laid a foundation for further clinical translation.

Advances of adipose-derived mesenchymal stem cells-based biomaterial scaffolds for oral and maxillofacial tissue engineering

The management of oral and maxillofacial tissue defects caused by tumors,trauma,and congenital or acquired deformities has been a major challenge for surgeons over the last few decades.Autologous tissue transplantation,the gold standard of tissue reconstruction,is a valid method for repairing the oral and maxillofacial functions and aesthetics.However,several limitations hinder its clinical applications including complications of donor sites,limited tissue volume,and uncertain long-term outcomes.Adipose-derived mesenchymal stem cells(ADMSCs)widely exist in adipose tissue and can be easily obtained through liposuction.Like the bone marrow-derived mesenchymal stem cells(BMSCs),ADMSCs also have the multi-pluripotent potencies to differentiate into osteoblasts,chondrocytes,neurons,and myocytes.Therefore,the multilineage capacity of ADMSCs makes them valuable for cell-based medical therapies.In recent years,researchers have developed many candidates of ADMSCs-based biomaterial scaffolds to cater for the needs of oral and maxillofacial tissue engineering due to their superior performance.This review presents the advances and applications of ADMSCs-based biomaterial scaffolds,and explores their tissue engineering prospects in oral and maxillofacial reconstructions.

Craniofacial resection of advanced oral and maxillofacial malignant tumors

Objective To evaluate the clinical outcome of craniofacial resection for advanced malignant tumors in oral and maxillofacial regions.Methods Forty-six patients who underwent craniofacial resection for malignancies involving the anterior and middle cranial fossa over a 20-year period between June 1978 and December 1997 at our department were evaluated. Twenty patients received radiation therapy and an adjuvant therapy after the operation. Eleven patients received chemotherapy of various types as an adjuvant therapy.Results The 3- and 5-year survival rates were 48.8% (20/41) and 35.1% (13/37), respectively, while the 10-year survival rate was 20% (4/20).Conclusions Our results revealed good prospects of using craniofacial resection on patients with advanced malignancies in the oral and maxillofacial regions.

Bone regeneration by stem cell and tissue engineering in oral and maxillofacial region

Clinical imperatives for the reconstruction of jaw bone defects or resorbed alveolar ridge require new therapies or procedures instead of autologous/allogeneic bone grafts.Regenerative medicine,based on stem cell science and tissue engineering technology,is considered as an ideal alternative strategy for bone regeneration.In this paper,we review the current choices of cell source and strategies on directing the osteogenic differentiation of stem cells.The preclinical animal models for bone regeneration and the key translational points to clinical success in oral and maxillofacial region are also discussed.We propose comprehensive strategies based on stem cell and tissue engineering researches,allowing for clinical application in oral and maxillofacial region.

CURRENT MEANS IN THE DIAGNOSIS AND TREATMENT OF ORAL AND MAXILLOFACIAL TUMORS IN CHINA

Oral and maxillofacial tumors (OMT) constitute a great number in tumors of head and neck as a whole. The incidence of OMT in China is rather low. but. owing to our big population, the absolute number of the patients is high. The diagnosis and treatment of OMT in China with special emphasis on malignancies are briefly introduced below.

Research Progress on the Application of Three-dimensional CT Imaging Technology in Oral and Maxillofacial Region and Radiation Protection

The anatomic relationship of oral and maxillofacial region is very com-plex,due to the large number of sinuses,cavities and spaces,and also closely related to the brain.The diagnosis of oral and maxillofacial lesions usually depends on the imaging examination.The conventional imaging methods are common CT and X-ray plain films.In recent years,with the rapid development of medical science and technology,more intuitive and vivid three-dimensional images have been applied in the diagnosis and treatment of oral and maxillofacial diseases.Therefore,CT three-dimensional imaging technology has been widely used in clinical practice.This paper reviews this topic.

中国口腔颌面外科专科医师培训和教育指南

中华口腔医学会口腔颌面外科专业委员会(Chinese Society of Oral and Maxillofacial Surgery,简称CSOMS)是国际口腔颌面外科医师协会(IAOMS)和亚洲口腔颌面外科医师协会(AsianAOMS)成员。本培训和教育指南的制定,是为了提高患者在接受口腔颌面部疾病诊治过程中的医疗水平和条件。对于直接参与这些医疗工作的口腔颌面外科医师来讲,他们的专业水平和所接受的专业培训教育水平是其所提供医疗服务水平高低的决定性因素。

Promoting lacunar bone regeneration with an injectable hydrogel adaptive to the microenvironment

Injectable hydrogel is suitable for the repair of lacunar bone deficiency.This study fabricated an injectable,self-adaptive silk fibroin/mesoporous bioglass/sodium alginate(SMS)composite hydrogel system.With controllable and adjustable physical and chemical properties,the SMS hydrogel could be easily optimized adaptively to different clinical applications.The SMS hydrogel effectively showed great injectability and shapeability,allowing defect filling with no gap.Moreover,the SMS hydrogel displayed self-adaptability in mechanical reinforcement and degradation,responsive to the concentration of Ca2+and inflammatory-like pH value in the microenvi-ronment of bone deficiency,respectively.In vitro biological studies indicated that SMS hydrogel could promote osteogenic differentiation of bone marrow mesenchymal stem cells by activation of the MAPK signaling pathway.The SMS hydrogel also could improve migration and tube formation of human umbilical vein endothelial cells.Investigations of the crosstalk between osteoblasts and macrophages confirmed that SMS hydrogel could regulate macrophage polarization from M1 to M2,which could create a specific favorable environment to induce new bone formation and angiogenesis.Meanwhile,SMS hydrogel was proved to be antibacterial,especially for gram-negative bacteria.Furthermore,in vivo study indicated that SMS could be easily applied for maxillary sinus elevation,inducing sufficient new bone formation.Thus,it is convincing that SMS hydrogel could be potent in a simple,minimally invasive and efficient treatment for the repair of lacunar bone deficiency.