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Reducing relapse and accelerating osteogenesis in rapid maxillary expansion using an injectable mesoporous bioactive glass/fibrin glue composite hydrogel

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Bioactive Materials 2022年第12期7卷 507-525页

作者： Hanjiang Zhao Xiangyu Wang Anting Jin Minjiao Wang Zeying Wang Xingtai Huang Jiewen Dai Xudong Wang Dan Lin Steve GF.Shen Department of Oral&Cranio-Maxillofacial Surgery Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineCollege of StomatologyShanghai Jiao Tong UniversityNational Clinical Research Center for Oral DiseasesShanghai Key Laboratory of Stomatology&Shanghai Research Institute of StomatologyShanghai200011PR China Shanghai University of Medicine and Health Sciences Shanghai201318China

rapid maxillary expansion(RME),as a common treatment for craniomaxillofacial deformity,faces the challenge of high relapse rates and unsatisfactory therapeutic effects.In this study,a standardized Sprague-Dawley(SD)rat RME model was first established with a modified expander as well as retainer design and optimized anterior maxillary expanding force of 100 g which exerted the most synchronized mobility of mid-palatal suture and incisors.Via the standardized model,the high relapse rate was proven to be attributed to insufficient osteogenesis in expanded suture,requiring long-term retainer wearing in clinical situations.To reduce the relapse rate,mesoporous bioactive glass/fibrin glue(MBG/FG)composite hydrogels were developed for an in situ minimal invasive injection that enhance osteogenesis in the expanded palate.The component of 1 wt%MBG was adopted for enhanced mechanical strength,matched degradation rate and ion dissolution,excellent in vitro biocompatibility and osteoinductivity.Effects of 1%MBG/FG composite hydrogel on osteogenesis in expanded mid-palatal sutures with/without retention were evaluated in the standardized model.The results demonstrated that injection of 1%MBG/FG composite hydrogel significantly promoted bone formation within the expanded mid-palatal suture,inhibited osteoclastogenesis and benefited the balance of bone remodeling towards osteogenesis.Combination of retainer and injectable biomaterial was demonstrated as a promising treatment to reduce relapse rate and enhance osteogenesis after RME.The model establishment and the composite hydrogel development in this article might provide new insight to other craniomaxillofacial deformity treatment and design of bone-repairing biomaterials with higher regenerative efficiency.

关键词： rapid maxillary expansion Sutural distraction osteogenesis Injectable hydrogel Mesoporous bioactive glass Bone regeneration

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Alternatives to surgery in children with mild OSA

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2021年第3期7卷 228-235页

作者： David Gozal Mahmoud Ismail Pablo E.Brockmann Department of Child Health and Child Health Research Institute and MU Women and Children’s HospitalUniversity of Missouri School of MedicineColumbiaMOUSA Department of Neurology and Sleep Medicine University of Missouri School of MedicineColumbiaMOUSA Department of Pediatric Cardiology and Pulmonology Division of PediatricsSchool of MedicinePontificia Universidad Católica de ChileSantiagoChile Pediatric Sleep Center School of MedicinePontificia Universidad Católica de ChileSantiagoChile

Precision medicine requires coordinated and integrated evidence-based combinatorial approaches so that diagnosis and treatment can be tailored to the individual patient.In this context,the treatment approach to mild obstructive sleep apnea(OSA)is fraught with substantial debate as to what is mild OSA,and as to what constitutes appropriate treatment.As such,it is necessary to first establish a proposed consensus of what criteria need to be employed to reach the diagnosis of mild OSA,and then examine the circumstances under which treatment is indicated,and if so,whether and when anti-inflammatory therapy(AIT),rapid maxillary expansion(RME),and/or myofunctional therapy(MFT)may be indicated.

关键词： Obstructive sleep apnea Children Antiinflammatory Myofunctional therapy rapid maxillary expansion Adenotonsillectomy

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Dental and skeletal changes with RME:a systematic review

Dental and skeletal changes with RME:a systematic review

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中华口腔医学会第14次全国口腔医学学术会议（2012年...

作者： Stomatology Chen Jieyu Supervisor:Cao Yang

rapid maxillary expansion is a common orthodontic treatment used for coorrrection of posterior crossbite resulting from reduced maxillary width. Evidence-based medicine has been defined as the process of "systematically finding, appraising,and using contemporary research as the basis of clinical practice".The authors conducted a literature review to evaluate the immediate and long-term transverse,anteroposterior,and vertical dental and skeletal changes produced by rapid maxillary expansion. Objectives:The objective was to evaluate immediate and long-term transverse, anteroposterior and vertical skeletal changes after rapid maxillary expansion(RME). Methods:The authors reviewed clinical trials that assessed dental and /or skeletal changes after RME using cephalometric analysis,model casts,CBCT.No surgical or other simultaneous treatment was accepted during the evaluation period. Electronic databases(PubMed,Medline,Medline,Embase,CNKI,VIP,WANFANG )were searched with the help of a senior librarian.Abstracts that appeared to fulfill the initial selection criteria were selected by consensus.The original articles were then retrieved.A methodological checklist was used to evaluate the quality of the selected articles. Results:The authors search electronic databases and also hand-searched for possible missing articles,found 15 articles,however they had methodological deficiencies.The author pooled measurement landmarks that were reported in two or more homogeneous studies into a meta analysis.The heterogeneous studies were statistically described. Conclusion:The greatest changes resulting from RME in the studies analyzed were dental and skeletal transverse changes.The anchored maxillary first molars were tipping.Few vertical and anteroposterior immediate changes were statistically significant.The long-term changes in vertical and anteroposterior were not clinically important.

关键词： rapid maxillary expansion systematic review meta analysis skeletal changes dental changes

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