Wenbin Wei

Superior half of the sternoclavicular joint pedicled with the sternocleidomastoid muscle for reconstruction of the temporomandibular joint: a preliminary study with a simplified technique and expanded indications

The sternoclavicular joint (SCJ) has similar anatomical and physical characteristics to the temporomandibular joint (TMJ). The purpose of this article is to introduce a modified technique for the pedicled SCJ and the expanded indications for its use. During the period June 2011 to June 2014, six TMJs were reconstructed using the superior half of the SCJ pedicled with the sternocleidomastoid muscle. The inclusion criteria were (1) poor vascularization jeopardizing a non-vascularized TMJ replacement, and/or (2) a large defect of both bone and soft tissue. The average follow-up period was 14.8 months (range 7-39 months). Fracture of the clavicle occurred in one patient (16.7%). No recurrence, graft resorption, or secondary deformity was found. Reconstruction of the TMJ using the superior half of the SCJ pedicled with the clavicle head of the sternocleidomastoid muscle and sternocleidomastoid branch of the superior thyroid artery benefited patients who had a poor blood supply and a medullary condition or who had a defect in both the condyle and surrounding soft tissue.

Preservation of the inferior alveolar neurovascular bundle in the osteotomy of benign lesions of the mandible using a digital template

Our aim was to evaluate the effect of a digital template in the preservation of the inferior alveolar neurovascular bundle during osteotomy for benign lesions of the mandible in 6 patients who were treated with mandibular osteotomies during 2013. Computed tomographic (CT) data were imported into ProPlan CMF 1.4 software. The borders of the lesion and the inferior alveolar canal were marked, and a digital template designed to mark the borders, outline the canal, and guide the osteotomy. A mirror image of the unaffected mandible was used to make a stereolithographic model by a rapid prototyping technique to prefabricate the reconstruction plate for the bone graft. The accuracy of the designs and the templates was evaluated during operation and postoperatively by CT. The sensation of the skin was tested using a Neurometer® CPT (current perception threshold) sensory detector (Neurotron Inc, Baltimore USA) to evaluate the function of the preserved inferior alveolar neurovascular bundle during follow up. With the digital template it was possible to guide removal of the bony lesion while accurately protecting the neurovascular bundle. Follow up for a mean of 8 months (range 5 -12) showed good facial symmetry, a stable occlusion, and recovery of sensation in the lower lip on the affected side. We conclude that a digital template can successfully help the resection of benign lesions of the mandible while preserving the function of the inferior alveolar neurovascular bundle.

Synovial chondromatosis of the tempromandibular joint: Relationship between MRI information and potential aggressive behavior

PURPOSE To evaluate the types of synovial condromatosis (SC) of tempromandibular joint (TMJ) on MRI and their potential aggressive behavior. METHODS 144 patients with pure SC of TMJ were included in. On MRI, 3 types of the lesion included loose body, homogeneous mass, and mixture of both loose body and homogeneous mass. Bony evaluations included 4 stages of erosion: without erosion, chondral breakdown, bony absorption and bony perforation. RESULTS 47 (32.6%) cases were categorized in the type of loose body, 71 (49.3%) cases in the type of homogeneous mass, and 26 (18.1%) cases in the type of mixture. 80% of bony perforation belonged to the type of homogeneous mass and 20% belonged to the type of mixture. 2 patients were found recurrence. CONCLUSION The types of homogeneous mass and mixture of both on MRI were more aggressive. Homogeneous mass with bony erosion on MRI had potential recurrence.

Three-Dimensional Reconstruction of the Distribution of Neurons Contributing to Ophthalmic, Maxillary, and Mandibular Nerves in the Trigeminal Ganglion of Experimental Model

Abstract The authors introduce a new method to build a three-dimensional (3D) model of the 3 branches of the trigeminal nerve in the trigeminal ganglion of rabbit with 3 different kinds of fluorescence. Ten adult New Zealand rabbits of both sexes weighing between 2.0 and 3.0 kg were used in the experiment. Then through an operation under general anesthesia, the maxillary and mandibular nerves were exposed, and red and gold fluorescence were applied to investigate the neurons of the maxillary and mandibular nerves. Subsequently, DiI was used as a marker for the ophthalmic neuron for the other side of the same rabbit. After receiving images of the 3 branches under a fluorescence microscope, a 3D model of the 3 branches of the trigeminal nerve could be built. The authors obtained an image of the 3 branches of neurons in the trigeminal ganglion, and a 3D model of the 3 branches of the trigeminal nerve in the trigeminal ganglion was reconstructed. In the trigeminal ganglion, ophthalmic neurons were concentrated in the anteromedial section, the maxillary division in the middle, and the mandibular division posterolaterally. Overlap was observed between the ophthalmic and maxillary neurons, and also for the maxillary and mandible neurons.

Does Idiopathic Bone Cavity Involving Mandibular Condyle Need Surgical Intervention of Bone Cavity Filling

Abstract Idiopathic bone cavity (IBC) is a rare, asymptomatic, unilateral, oval-shaped radiolucent defect in the mandible. It is extremely rare that IBC occurs in the mandibular branch and condylar process. This article presents a 16-year-old male with IBC occuring in the mandibular branch.

Monofocal Chronic Nonbacterial Osteomyelitis in the Mandible Accompanied With Mucocutaneous Disease.

Abstract Chronic nonbacterial osteomyelitis (CNO) is a bone disease with nonbacteria osteitis of unknown etiology. Symptoms, including pain, swelling, fever, etc, always result in misdiagnosis and wrong therapy. This study aims to introduce the clinical features and the therapy of patients with CNO accompanied with mucocutaneous disease. The authors retrospectively reviewed the patients who presented to our hospital from 2000 to 2016, the final sample including 3 patients with CNO accompanied with mucocutaneous disease, who presented repeated severe pain of bone, swelling, tenderness, and fever during attack stage with no evidence of bacterial infections. One patient underwent surgery, and all of them took the therapy of nonsteroidal anti-inflammatory drugs and immunosuppressive agents. There was no significant effect after taken surgery, but good results with drugs. The study suggested us that medical therapy sometimes better than surgery in CNO accompanied with mucocutaneous disease.

Surgical Therapy for Pure Trigeminal Motor Neuropathy Accompanied by Limited Mouth Opening: A Retrospective Study

Purpose: This study aims to find out if there is any new manifestation of pure trigeminal motor neuropathy and evaluated the long-term results of surgery for its treatment. Patients and methods: The present study includes 10 patients referred from December 2003 to June 2014. The clinical manifestation investigations were recorded and 3 patients with limited mouth-opening were operated. The longterm follow-up result was performed. Results: Among 10 patients, 6 suffered from limited mouth opening, the other 4 jaw deviation. Among patients who had difficulty in mouth-opening, 3 patients chose surgery to improve the situation, the others just follow-up. At the final follow-up, the average maximum mouth opening of operated patients totally increased by 180%. For non-operated patients, no obvious improvement of mouth opening was observed. Conclusion: Limitation on mouth-opening is another manifestation of pure trigeminal motor neuropathy and surgery can effetely improve the situation.