Chi Yang

Shanghai Jiao Tong University, Shanghai, Shanghai Shi, China

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Publications (130)150.27 Total impact

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    ABSTRACT: This study aimed to evaluate the changes of temporomandibularjoint (TMJ) space in the treatment of disk displacement with reduction (DDWR) for class II cases. Forty-two adolescent patients with unilateral DDWR, who were successfully treated by functional appliance, were selected in this study. Magnetic resonance imaging scans were used before treatment (T1), at the start of treatment (T2), and after functional treatment (T3). Compared with the normal joint, the change of joint space index was calculated. The anterior, posterior, and superior joint spaces were analyzed on the largest sagittal plane among T1, T2, and T3. Student's t-test was used for statistical analysis. The mean treatment period was 10 months (6-16 mo). Functional appliance was effective in eliminating pain and clicking. During the phase of T1, the value of the joint space index of DDWR was significantly higher than that of the control (P < 0.05). There was a significant decrease in the anterior space and an increase in the postsuperior space at T2 (P < 0.01), and then the contrary changes occurred at T3. However, there was a significant increase in the postsuperior space and no significant decrease in the anterior space when T1 and T3 were compared. This study indicates that the TMJ space is well distributed after disk repositioning with functional treatment of DDWR. It is also suggested that the adaptive remodeling in TMJ occurs via functional treatment.
    Journal of Craniofacial Surgery 03/2015; 26(2):e78-81. DOI:10.1097/SCS.0000000000001392 · 0.68 Impact Factor
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    ABSTRACT: Dentigerous cyst (DC) in the maxillary sinus is rarely seen. Several complications are observed after the Caldwell-Luc operation, which is combined with endoscopy. Still, a more perfect treatment method is yet to be discovered. The purpose of this study was to explore and assess a new functional surgical treatment with fewer complications, which not only insured normal maxillary sinus cilia restoration and bony integrity but also did little damage to maxillary sinus natural ostium. Dentigerous cyst in the maxillary sinuses of 20 patients had conditions diagnosed through radiographic imaging and the locating of bone windows' positions according to preoperative 3-dimensional computed tomography (CT) (3D CT). All the patients underwent a functional surgery in which a bony lid was created anteriolaterally of maxillary sinus with piezosurgery and reimplanted by titanium plates after enucleating the cyst, leaving the maxillary sinus mucosa in place with or without endoscope's assistance. Therapeutic efficacy was evaluated by clinical examination and radiographic imaging at regular intervals; the longest follow-up was 24 months. All the patients recovered except for one, who underwent plate removal and radical maxillary sinusotomy owing to infection. Patients were asymptomatic, and CT images showed integrated maxillary bone. Extrusion deformation of the sinus was improved to different extents after 6 to 24 months of follow-up. Functional surgery for the treatment of DC in the maxillary sinus is a new approach and has the advantages of less surgical trauma, restoration of mucosa and bony wall, and more satisfactory results.
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    ABSTRACT: Pigmented villonodular synovitis is an uncommon benign tumor-like proliferative lesion with an undetermined origin. Involvement of the temporomandibular joint is uncommon. Although pigmented villonodular synovitis is a benign lesion, it can grow with an aggressive pattern, and it extends extra-articularly in most of the reported cases, about one-third of them exhibiting intracranial involvement. The authors reported an additional case of a 47-year-old woman with intracranial extension, who had a history of joint pain and trismus. The preoperative diagnosis was made with arthroscopy. The lesion was completely excised via preauricular approach and condylotomy. The bone defect was covered by the pedicled temporalis myofascial fat flap. The patient has been symptom-free for 40 months postoperatively.
    Journal of Craniofacial Surgery 02/2015; DOI:10.1097/SCS.0000000000001341 · 0.68 Impact Factor
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    ABSTRACT: This study aims to identify significant predictors of 3 outcomes in the aged patients and non-elderly with multi-space infections of the head and neck: the number of incisions, the length of hospital stay, and complications. A retrospective study was conducted on 242 patients receiving treatment for severe multi-space infections of the head and neck region. Study variables were categorized as demographics, clinical parameters, and laboratory values. The outcome variables were the number of incisions, length of hospital stay, and complications. Multivariate linear and logistic regression techniques were used to measure associations between study variables and the outcome variables. Statistical analyses of the results between groups were performed using the Student t test and χ. Multivariate analyses, controlling for confounding variables, indicated that the number of spaces affected was a predictor of the number of incisions and complications in the elderly group. In the non-elderly group, the number of spaces affected was a predictor of the number of incisions and length of hospital stay. Admission blood glucose level and admission white blood cell count were the predictors of complications in the non-elderly. This study identifies different study variables as predictors of outcomes in treating multi-space infections of the head and neck in the elderly and non-elderly group. The number of spaces affected is the most important predictor.
    Journal of Craniofacial Surgery 02/2015; DOI:10.1097/SCS.0000000000001465 · 0.68 Impact Factor
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    ABSTRACT: Myositis ossificans (MO) is a disease where heterotropic bone forms within a muscle or other type of soft tissue. MO is classified into two groups, MO progressiva and post-traumatic MO. It rarely occurs in the masticatory muscles and thus, only 20 cases involving the masticatory muscles have been reported since 2001. The majority of the reported cases occurred due to trauma, repeated injury or surgical manipulation. However, in a small number of cases, no specific traumatic event was identified as the cause of MO. To the best of our knowledge, this is the first case of post-infectious MO to be reported in the medial and lateral pterygoid muscles.
    Oncology letters 02/2015; 9(2):920-926. DOI:10.3892/ol.2014.2710 · 0.99 Impact Factor
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    ABSTRACT: Our aim was to assess the efficacy of piezoelectric corticotomy for orthodontic traction of mandibular third molars close to the inferior alveolar nerve. Thirty patients with impacted third molars close to the nerve were included in the study, 15 of whom were treated with conventional orthodontic traction and 15 with piezoelectric corticotomy. We recorded duration of treatment including exposure and orthodontic traction, and time to the final extraction. Postoperative complications including trismus, swelling, and pain were also noted. Alveolar bone levels mesial and distal to the second molars were evaluated on cone-beam computed tomographic (CT) images. Student's t test was used to assess the significance of differences between the groups. After orthodontic treatments all impacted third molars were successfully removed from the inferior alveolar nerve without neurological damage. The mean (SD) duration of surgical exposure in the piezoelectric corticotomy group was significantly longer than that in the conventional group (p = 0.01). The mean (SD) duration of traction was 4 (2.3) months after piezoelectric corticotomy, much shorter than the 7.5 (1.3) months in the conventional group (p = 0.03). There were no significant differences in postoperative complications between the groups. There was a significant increase in the distal alveolar height of second molars after treatment in both groups (p < 0.01). We conclude that the use of piezoelectric corticotomy allows more efficient and faster traction of third molars with a close relation between the root and the inferior alveolar nerve, although it took longer than the traditional technique.
    British Journal of Oral and Maxillofacial Surgery 01/2015; DOI:10.1016/j.bjoms.2015.01.002 · 1.13 Impact Factor
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    ABSTRACT: To evaluate the types of synovial condromatosis (SC) of tempromandibular joint (TMJ) on MRI and their potential aggressive behavior. 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. 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. The types of homogeneous mass and mixture of both on MRI were more aggressive. Homogeneous mass with bony erosion on MRI had potential recurrence. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
    Journal of Cranio-Maxillofacial Surgery 01/2015; DOI:10.1016/j.jcms.2015.01.011 · 2.60 Impact Factor
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    ABSTRACT: The goal of the study was to investigate the production of COL2A1, SOX9, ALP, Runx2, Ihh and PTHrP in mandibular condylar chondrocytes under static pressure stimuli
    Archives of Oral Biology 01/2015; 60(4). DOI:10.1016/j.archoralbio.2015.01.003 · 1.88 Impact Factor
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    ABSTRACT: Objective: We aimed to investigate the correlation between the disc status in MRI and different types of traumatic temporomandibular joint (TMJ) ankylosis. Methods: 51 consecutive patients (69 joints), diagnosed as traumatic TMJ ankylosis with a residual condyle (types A2 and A3), were included in this study. All patients had a preoperative MRI, which was reviewed to determine the disc shape, length, and position. The results were compared using the Mann-Whitney test. Results: There were 37 joints of type A2 ankylosis and 32 joints of type A3. All joints of type A2 and 27 joints of type A3 (84.4%) definitely had a discernible disc, while 5 joints of type A3 had no discernible discs. Among the discernible discs, the lateral disc of type A2 and the whole disc of type A3 had severe deformity, while the medial disc of type A2 had mild deformity. The mean (SD) disc length in type A2 was 10.88 (1.19) mm, while in type A3 it was 7.50 (0.82) mm. There was a significant difference between types A2 and A3 (P<0.05). As for the disc position, the intermediate position was found in all joints. Conclusions: There is a correlation between the disc status and different types of traumatic TMJ ankylosis. Therefore, we need to have an MRI examination to help treatment planning and predict the postoperative TMJ functions.
    Dento-maxillo-facial radiology. Supplement 01/2015; 44(4):20140201. DOI:10.1259/dmfr.20140201
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    ABSTRACT: The study was aimed to determine and optimize the parameters for the MR fast imaging employing steady-state acquisition (FIESTA) sequence, which was to obtain an acceptable image to evaluate the value of the movement of the temporomandibular joint (TMJ). In this investigation, 20 volunteers were examined to determine and optimize the parameters of the FIESTA sequence. Then, 160 TMJs from 80 patients with temporomandibular joint disorders (TMD) of clinical suspicion were consecutively performed by both static MRI and dynamic FIESTA MRI on the oblique sagittal position. The FIESTA MR images of TMJs were obtained from a slow, consecutive, free and open-closed movement. Based on the cycles of TMJ movements during the process of FIESTA MRI (90seconds), we classified all TMJs into 2 groups: cycles of open-closed mouths less than or equal to 3 (group 1) and more than 3 (group 2). Each image was marked level 1-3 by its quality. Meanwhile, the location of articular disc, mandibular condyle, motive artifact, "jumping sign" and the joint effusion in each TMJ were assessed respectively. By dynamic FIESTA MRI among 160 TMJs, 92 TMJs (57.50%) were in group 1 and 68 TMJs were (42.50%) in group 2. There were statistically significant differences between group 1 and group 2(p<0.05). It was shown that the number of "level 3" in group 1 was greater than group 2, and the number of "level 1" in group 1 was less than group 2. The phenomenon of motion artifact and "jumping sign" were much significantly higher in group 2 than those in group 1 (p<0.01). Furthermore, in all of the "jumping sign" cases, the phenomenon of "jumping sign" was significantly higher in group ADDwR than in group ADDw/oR (p<0.01). There was a statistically significant correlation between disc-condyle complex in "jumping sign" phenomenon and group ADDwR (r=0.621, p<0.05). The data with the false matching rate of 31.52% showed that the maximum motion range on the dynamic imaging was greater than the static imaging. Among 160 TMJs, joint effusions of 37 TMJs (23.13%) were identified by dynamic FIESTA-MRI. Among 79 TMJs with ADDw/oR(anterior disc displacement without reduction),42 sides were operated with Maxillofacial arthroscopy surgery. The surgical result was in agreement with the MR result. Most TMJs images with a slow free open-close movement (cycles≦3) could be successfully obtained by the dynamic FIESTA MRI. The FIESTA MRI might be considered as an additional method to evaluate the movement of the articular disk and the mandibular condyle. Copyright © 2014. Published by Elsevier Inc.
    Magnetic Resonance Imaging 11/2014; 33(3). DOI:10.1016/j.mri.2014.10.013 · 2.02 Impact Factor
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    ABSTRACT: To investigate the prevalence of mandibular asymmetry (MA) within the symptomatic unilateral anterior disc displacement (ADD) patients, and analyze the influence TMJ factors of the MA severity.Methods Patients aged under 20 years old with symptomatic unilateral ADD and asymptomatic volunteers with normal disc-condyle relationship diagnosed by magnetic resonance imaging (MRI) were included in this study. Posteroanterior cephalometric radiographs were taken to measure MA. Condylar height, disc length and disc displacement were measured by MRI. The prevalence and severity of MA were compared between the ADD and the control groups. The correlation between the severity of MA with the amount of condylar height shortage, disc deformity and distance of disc displacement were also evaluated within the ADD group.ResultsThere were 165 cases in the unilateral ADD group, and 156 cases in the control group. One hundred and nineteen cases had MA which accounted 72.12% (119/165) in the ADD group; while in the control group, only 25.64% (40/156) exhibited MA. The mean horizontal menton deviation and condylar height shortage in the unilateral ADD group were significantly larger than that in the control group (5.62mm vs. 4.19mm; 3.14mm vs. 1.32mm, p<0.01). The severity of MA was significantly correlated with the amount of disc displacement, disc deformity and condylar height shortage (correlation coefficient: 0.80, 0.70, and 0.82).ConclusionMA is much more common and severe in young unilateral ADD patients. The severity of MA is correlated with the height of condyle and the status of the disc.
    Journal of Cranio-Maxillofacial Surgery 10/2014; DOI:10.1016/j.jcms.2014.10.013 · 2.60 Impact Factor
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    ABSTRACT: Objective: The aim of this study was to compare the disc positions and condylar changes induced by different stretching forces in the modified animal model for anterior disc displacement (ADD) of the temporomandibular joint. Methods: In the experimental group, 30 rabbits were equally divided into 3 subgroups and underwent surgical ADD via different stretching forces: group A with 0.5 N, group B with 1 N, and group C with 2 N. In the sham group, 6 rabbits underwent the same surgery without the disc being pulled anteriorly. The diagnosis of ADD was made when the anterior band of the disc was located anteriorly to the articular eminence. Histologic and radiographic changes of the condyles were observed under light microscopy and micro-computed tomography scanning 1 week after surgery. Results: The success rates of ADD were both 100% in groups B and C and 70% in group A. The correlations between the stretching force and severity of ADD, the stretching force and severity of cartilage changes, and the severity of ADD and cartilage changes were statistically significant (P < 0.01). The most advanced ADD and severest condylar changes were induced in group C. Condylar remodeling and scleroses were found in micro-computed tomography scans. Conclusions: The rabbit model for ADD has been successfully established in this study, which is feasible and minimally invasive. The stretching force of at least 1 N could induce the disc displaced successfully. Larger stretching force would induce severer ADD and condylar degenerative changes.
    Journal of Craniofacial Surgery 10/2014; 25(6). DOI:10.1097/SCS.0000000000001065 · 0.68 Impact Factor
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    ABSTRACT: Objective To evaluate the stability of our custom-made prosthesis by establishing the model of sheep total temporomandibular joint(TMJ) replacement. Methods Six sheep were included in our study. Spiral computed tomography (CT) data of all sheep was obtained and transformed into 3-dimensional model by surgicase5.0 software preoperatively. Total TMJ prostheses were made based on the skull model. Ultra-high molecular weight polyethylene was used to make glenoid fossa lining, while titanium alloy to prefabricate mandibular retention handle and titanium plate over glenoid fossa. Cobalt-chromium-molybdenum alloy was also used to prefabricate the condyle. The right sides of all sheep, as the experimental group, were carried out total TMJ replacement, while the left sides were as the control group. The bone in both experimental and control side were excised after 3 and 6 months. scanning electron microscope(SEM) was used to observe the interface between bone and prosthesis. Van Gieson staining and immunohistochemical staining(IHC) were used respectively to observe the interface of titanium screw and bone and the expression of alkaline phosphatase(ALP). Results SEM and Van Gieson staining showed that there was immature bone and osteoid formed in the interface of prosthesis and bone after 3 months. While after 6 months, there was osseointegration between them. IHC showed that the expression of ALP in the experimental side was much higher than in the control side after 3 months and its expression decreased after 6 months with no difference from the control side. Conclusion The custom-made TMJ prosthesis which was designed and manufactured by ourselves has good stability after total TMJ replacement.
    Journal of Cranio-Maxillofacial Surgery 10/2014; DOI:10.1016/j.jcms.2014.03.008 · 2.60 Impact Factor
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    ABSTRACT: Objective To investigate the difference of serological profile in pSS and their correlation with the clinical characteristics of parotid glands. Methods This retrospective study includes 289 patients who fulfilled the 2002 American-European Consensus Group Criteria for pSS. The patients were categorized by the clinical features of parotid glands: Group1 (massive group), Group 2 (infection group), Group 3 (swelling group) and Group 4 (others). The demographic data and serological profiles among these groups were compared. Statistical analyses of the results between groups were performed using the Student t test, Fisher’s exact test, chi-square and analysis of variance. Results There was a difference of serological profile in the different clinical characteristics of parotid glands of pSS. Serum Ig G value of Group 1 was the greatest, and complement C4 was lowest in the four groups. Serum Ig E value of Group 2 was the greatest and ESR of Group 3 was the greatest in the four groups. Conclusion This study has determined the differences of serological profile in the different clinical features of parotid glands of pSS patients, which may help advance our understanding of the disease and improve patient management.
    Journal of Cranio-Maxillofacial Surgery 10/2014; DOI:10.1016/j.jcms.2014.03.007 · 2.60 Impact Factor
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    ABSTRACT: OBJECTIVE To investigate the diagnostic accuracy of magnetic resonance imaging (MRI) for perforation of temporomandibular joint (TMJ). METHODS Consecutive 1845 patients (2524 joints) diagnosed as internal derangement(ID) of TMJ were collected from April 2003 to March 2010 in our department. All the patients were examined by MRI and treated by arthroscopy or open surgeries. The findings of interpreting MRI were recorded as positive, suspicious and negative according to the MRI radiographic criteria. After comparing the findings of MRI with those of arthroscopy or open surgeries, the numbers of true positive, true negative, false positive and false negative were obtained. Through SPSS16.0, receiver operator characteristic curve(ROC curve) was made with 1-specificity as abscissa and the sensitivity as ordinate, and the area under the ROC curve was calculated. According to the area, the diagnostic value of MRI was evaluated. RESULTS Arthroscopic or open surgeries findings confirmed that 207 joints had disc perforation among all joints. MRI findings showed 189 joints were positive, 197 joints suspicious, and 2138 joints negative. The true positive accuracy of MRI findings was 102/189 while true negative accuracy was 2075/2138. 42 of the 197 suspicious joints had perforation. The area under the ROC curve was 0.808(0.77, 0.85), P < 0.05. CONCLUSION We concluded that MRI proved to be a good modality to diagnose disc perforation of TMJ, and the diagnostic result of disc perforation by MRI had certain guiding significance in our clinical work.
    Journal of Cranio-Maxillofacial Surgery 09/2014; 42(6). DOI:10.1016/j.jcms.2014.01.001 · 2.60 Impact Factor
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    ABSTRACT: Purpose Evaluate the effectiveness of computer-generated surgical templates for precise bone removal in the treatment of temporomandibular joint (TMJ) ankylosis with a medially displaced condyle. Methods Patients found to have a medially displaced condylar head and lateral bony fusion between January 2012 and January 2014 were included in the study. ProPlan CMF 1.4 software (Materialise Medical, Leuven, Belgium) was used to design the osteotomies for the lateral bony fusion while protecting the medial condylar head. Surgical templates were fabricated to transfer the design to the operation and the effectiveness evaluated post-operatively using CT scan comparisons. Results :In 5 surgeries with a total of 7 joints the surgical templates fit well and accurately guided the osteotomies. The skull base, external auditory canal, major vessels and residual condyle were well protected. Postoperative CT difference-analysis calculated an average difference of 1.044mm. Conclusions Computer-assisted surgical templates were able to accurately guide bone removal, protect the residual condylar head, skull base and external auditory canal in the treatment of TMJ ankylosis.
    Journal of Oral and Maxillofacial Surgery 09/2014; DOI:10.1016/j.joms.2014.08.030 · 1.28 Impact Factor
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    ABSTRACT: The aim of this study was to introduce a modified endoscopic lift of the floor of the maxillary sinus in beagles. Twelve operations (bilateral and randomly chosen) were done in 6 beagles each in the test group (modified endoscopic operation), and the control group, in which the operation was done with an osteotome. All operations were evaluated by two indices of safety (perforation of the sinus membrane and nasal bleeding) and 3effective indices (the intraoperative height after lifting, volume of bone grafts, and dislocation of the sinus grafts). The sinus membrane was not perforated and there were no nasal bleeds in either group. The intraoperative height after lifting was 13.7 (0.8) mm in the test group and 9.1 (0.5) mm in the control group, so it was significantly higher in the test group than the control group (p=0.0001). Similarly, the volume of bone graft was 0.9 (0.04) ml in the test group and 0.5 (0.02) ml in the control group (p=0.0001). The volume of the anterior and posterior bone grafts in the implant cavity in the test group did not differ significantly (p=0.102), while there were significant differences in the control group (p=0.002). Endoscopic lifting of the floor of the maxillary sinus is a safe and effective approach based on direct observation in beagles.
    British Journal of Oral and Maxillofacial Surgery 08/2014; 52(9). DOI:10.1016/j.bjoms.2014.08.001 · 1.13 Impact Factor
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    ABSTRACT: To design and manufacture digital templates to guide Biomet total alloplastic joint replacement surgery (Biomet, Warsaw, IN) and evaluate the clinical efficacy.
    Journal of Oral and Maxillofacial Surgery 08/2014; DOI:10.1016/j.joms.2014.08.014 · 1.28 Impact Factor
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    ABSTRACT: Objective: The objectives of this study were to introduce the classification of osteochondroma of the mandibular condyle based on computed tomographic images and to present our treatment experiences. Materials and Methods: From January 2002 and December 2012, a total of 61 patients with condylar osteochondroma were treated in our division. Both clinical and radiologic aspects were reviewed. The average follow-up period was 24.3 months with a range of 6 to 120 months. Results: Two types of condylar osteochondroma were presented: type 1 (protruding expansion) in 50 patients (82.0%) and type 2 (globular expansion) in 11 patients (18.0%). Type 1 condylar osteochondroma presented 5 forms: anterior/anteromedial (58%), posterior/posteromedial (6%), medial (16%), lateral (6%), and gigantic (14%). Local resection was performed on patients with type 1 condylar osteochondroma. Subtotal condylectomy/total condylectomy using costochondral graft reconstruction with/without orthognathic surgeries was performed on patients with type 2 condylar osteochondroma. During the follow-up period, tumor reformation, condyle absorption, and new deformity were not detected. The patients almost reattained facial symmetry. Conclusions: Preoperative classification based on computed tomographic images will help surgeons to choose the suitable surgical procedure to treat the condylar osteochondroma.
    Journal of Craniofacial Surgery 08/2014; 25(5). DOI:10.1097/SCS.0000000000000898 · 0.68 Impact Factor
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    ABSTRACT: Anterior disc displacement is one of the most common conditions affecting the temporomandibular joint. In our previous publications we have reported on the basic technical elements of disc repositioning surgery. However, this article presents some critical modifications that have allowed us to perform this procedure safely and successfully over the past three years.
    Journal of Oral and Maxillofacial Surgery 07/2014; DOI:10.1016/j.joms.2014.06.452 · 1.28 Impact Factor

Publication Stats

365 Citations
150.27 Total Impact Points


  • 2009–2015
    • Shanghai Jiao Tong University
      • • Department of Oral and Maxillofacial Surgery
      • • School of Medicine
      Shanghai, Shanghai Shi, China
    • Binzhou Medical University
      Pei-chen, Shandong Sheng, China
  • 2010–2014
    • Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
      Shanghai, Shanghai Shi, China
  • 2009–2013
    • Renji Hospital
      Shanghai, Shanghai Shi, China
  • 2008–2013
    • Center For Oral & Maxillofacial Surgery
      Georgia, United States
  • 2002–2007
    • Second Military Medical University, Shanghai
      Shanghai, Shanghai Shi, China