Liu X, Wang F, Sun L
… +3 more, Cao Z, Yang Y, Fu H
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297619
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Second branchial cleft cyst and lymphoma are two common types of neck masses. The etiology, clinical manifestations, imaging findings, treatment options, and prognosis of these two entities differ. Clinically, the occurr...Second branchial cleft cyst and lymphoma are two common types of neck masses. The etiology, clinical manifestations, imaging findings, treatment options, and prognosis of these two entities differ. Clinically, the occurrence of both lesions at the same anatomical site is rare. Herein, we report a case of concurrent second branchial cleft cyst and diffuse large B-cell lymphoma in the same anatomical region. The final diagnosis was confirmed by clinical features, ima-ging findings, and ultrasound-guided biopsy. The patient received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy regimen combined with surgical resection and finally achieved patholo-gical complete response with a favorable prognosis. This case report aims to provide a reference for the diagnosis and treatment of similar cases.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297618
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The aesthetic restoration of severely discolored nonvital anterior teeth is a common clinical challenge. It is centered on achieving a balance between the effective masking of the substrate and the natural translucency o...The aesthetic restoration of severely discolored nonvital anterior teeth is a common clinical challenge. It is centered on achieving a balance between the effective masking of the substrate and the natural translucency of the restoration. This case report presents the treatment of a young female patient's four maxillary anterior teeth by using a digital workflow that integrates three-dimensional digital smile design with a double-layer ceramic technique. The technique featured a 0.5 mm resin-matrix ceramic inner layer for substrate masking and a 1.0 mm high-translucency zirconia outer layer for natural aesthetics. By combining digital precision with material science, this approach offers a reference for managing complex anterior aesthetic demands.
Jiang Y, Li Y, Zhang Y
… +6 more, Liu F, Li L, Deng S, Qin Y, Yu J, Qiu R
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297617
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OBJECTIVES: This study aims to evaluate the clinical effectiveness and cost-effectiveness of personalized topical fluoride intervention guided by the modified caries-risk assessment tool for preschool children (PSC-MCAT)...OBJECTIVES: This study aims to evaluate the clinical effectiveness and cost-effectiveness of personalized topical fluoride intervention guided by the modified caries-risk assessment tool for preschool children (PSC-MCAT) for preschool children in Jiangnan District of Nanning City and to provide evidence to support the implementation of community-based graded oral health interventions for preschooler children. METHODS: A total of 198 three-year-old children from Jiangnan District, Nanning City, were recruited and randomly assigned to a test or control group. Baseline data were collected through questionnaires and oral examinations. The test group received personalized topical fluoride treatments based on caries risk levels determined using the PSC-MCAT, whereas the control group received standard fluoride varnish application every six months. After 1.5 years of follow-up, the incidence of new caries and changes in mean dmft increment were analyzed. Cost-effectiveness analysis was conducted to assess economic benefits, and sensitivity analysis was performed to evaluate result stability. RESULTS: After 1.5 years, the test group demonstrated significantly lower caries incidence (50.9%) and △dmft (1.42±1.90) compared with the control group (68.9%, 2.74±2.92) (<0.05). Cost-effectiveness analysis indicated that the incremental cost to prevent one new case of caries in the test group was 559.66 yuan, which was lower than the willingness-to-pay threshold (626.77 yuan). The cost per prevented caries lesion was 153.80 yuan, which was lower than the direct treatment cost of 200.5 yuan per lesion. Sensitivity analysis indicated a 99.8% probability that the intervention is cost-effective at a willingness-to-pay of 626.77 yuan per person. CONCLUSIONS: The PSC-MCAT tool is effective and cost-effective for caries risk assessment and may serve as a practical framework for caries prevention.
Shao Y, Wang Y, Yu W
… +4 more, Xu Y, Xu J, Wang X, Chen Z
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297616
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OBJECTIVES: This study explored the expression of Rho-related BTB domain-containing protein 1 (Rho-BTB1) in tongue squamous cell carcinoma (TSCC) cells; its effects on TSCC cell proliferation, invasion, and migration; an...OBJECTIVES: This study explored the expression of Rho-related BTB domain-containing protein 1 (Rho-BTB1) in tongue squamous cell carcinoma (TSCC) cells; its effects on TSCC cell proliferation, invasion, and migration; and the underlying molecular mechanisms. METHODS: RhoBTB1 expression in TSCC was analyzed by querying a bioinformatics online database. Forty-five cases of primary TSCC lesions resected during oral and maxillofacial surgery from December 2024 to August 2025 were selected. Immunohistochemistry and Western blot were used to detect RhoBTB1 expression in TSCC tissues and adjacent tissues. Two kinds of TSCC cell lines, CAL-27 and SCC-25, were selected for experiments. The overexpression plasmid vector and small interfering RNA were designed on the basis of the RhoBTB1 gene sequence. TSCC cells were transiently transfected, and the transfection efficiency was evaluated by real-time quantitative polymerase chain reaction. The proliferation, invasion, migration, and apoptosis of TSCC cells were evaluated by CCK-8 assay, Transwell cell invasion assay, cell scratch assay, and flow cytometry respectively. The expression levels of RhoBTB1, Rho-related protein kinase 1 (ROCK1), phosphatase and tensin homologue (PTEN), phosphorylated phosphatase and tensin homologue (p-PTEN), protein kinase B (AKT), and phosphorylated protein kinase B (p-AKT) were analyzed by Western blot. SPSS 22.0 and GraphPad Pri 8.0 were used to analyze the experimental data. RESULTS: RhoBTB1 expression in TSCC tissues was significantly lower than that in adjacent tissues (<0.05). RhoBTB1 overexpression significantly inhibited the proliferation, invasion, and migration of TSCC cells, promoted their apoptosis, down-regulated ROCK1/p-AKT, and up-regulated p-PTEN (<0.05); no significant difference in expression was observed between PTEN and AKT (>0.05). Knockdown of RhoBTB1 yielded opposing effects, with the upregulation of ROCK1 and p-AKT and the downregulation of p-PTEN (<0.05). No significant differences were observed in the expression levels of PTEN and AKT (>0.05). CONCLUSIONS: RhoBTB1 is lowly expressed in TSCC and may inhibit its malignant phenotype by negatively regulating the ROCK1/PTEN/AKT pathway, suggesting its potential as an oncogene and therapeutic target.
Shang Y, Hu M, Che Z
… +3 more, Liu X, Deng Y, Yu W
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297615
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OBJECTIVES: This study aims to examine the protective effect of the peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist pioglitazone on renal injury linked to periodontitis in mice and to preliminarily expl...OBJECTIVES: This study aims to examine the protective effect of the peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist pioglitazone on renal injury linked to periodontitis in mice and to preliminarily explore the relationship between this effect and Klotho. METHODS: A total of 24 eight-week-old C57 mice were randomly assigned to three groups: control (C), periodontitis (P), and pioglitazone treatment (P+Pio). Silk ligation was employed to induce experimental periodontitis around the maxillary second molars, and pioglitazone was administered through oral gavage. After eight weeks, the mice were euthanized. The maxillae were subjected to Micro-CT scanning. Periodontal and kidney tissues underwent hematoxylin and eosin, periodic acid-Schiff, and Masson's trichrome staining. Renal ultrastructure was observed using transmission electron microscopy (TEM), and malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione (GSH) were measured. The levels of renal reactive oxygen species (ROS) were assessed through MitoSOX red fluorescence staining. Serum concentrations of creatinine (Cre), blood urea nitrogen (BUN), and albumin (Alb) were evaluated, in addition to urinary protein levels. The gene and protein expression levels of PPAR-γ, Klotho, phosphatidylinositol 3-kinase (PI3K), and serine/threonine kinase (AKT) were determined using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC). RESULTS: Micro-CT and periodontal histological analysis indicated substantial alveolar bone loss and heightened periodontal pocket depth in the second molar region of the P group relative to the C group. The P+Pio group exhibited reduced effects, compared with the P group. Histological examination of renal tissue and TEM revealed pathological damage in the P group. Pathological damage was alleviated in the P+Pio group. Biochemical assays and MitoSOX staining indicated that the P group demonstrated lower levels of SOD and GSH levels than the C group and increased MDA and ROS levels. Compared with the P group, the P+Pio group exhibited elevated levels of SOD and GSH and reduced levels of MDA and ROS. No notable differences were detected in Cre, BUN, and Alb levels across the groups. qRT-PCR and IHC revealed a reduction in PPAR-γ and Klotho expression levels in the renal tissues and an increase in PI3K and AKT expression levels in the P group compared with the C group. In the P+Pio group, the expression levels of PPAR-γ and Klotho were elevated relative to those of the P group, whereas expression levels of PI3K and AKT were decreased. CONCLUSIONS: Pioglitazone can alleviate renal damage associated with periodontitis in mice, and its effect may be related to the upregulation of Klotho expression.
Pang X, Liu C, Cui X
… +3 more, Liu J, Wang L, Pan J
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297614
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Randomized controlled trial (RCT) represent a type of study design wherein research subjects are randomly allocated to different groups to receive various interventions, allowing for the comparison of result differences...Randomized controlled trial (RCT) represent a type of study design wherein research subjects are randomly allocated to different groups to receive various interventions, allowing for the comparison of result differences and minimizing bias to the greatest extent possible. They are the primary source of evidence in evidence-based dentistry. Recently, an international team of dental experts has published the Preferred Reporting Items for Randomized Trials in Endodontics (PRIRATE) 2020 checklist, a set of guidelines aimed at enhancing the quality of design and reporting of RCTs contextualized to dentistry. We provide a detailed interpretation of the key items of the PRIRATE checklist, supplemented with specific examples, to promote the reporting of RCTs in China.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297613
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Anterior disc displacement without reduction (ADDwoR) is the most common type of temporomandibular disorders (TMDs). Surgical intervention remains one of the most important treatment modalities for this condition. With t...Anterior disc displacement without reduction (ADDwoR) is the most common type of temporomandibular disorders (TMDs). Surgical intervention remains one of the most important treatment modalities for this condition. With the increasing adoption of minimally invasive surgery (MIS) concepts in oral and maxillofacial surgery, implementing MIS principles in the surgical management of ADDwoR has become crucial. This article traces the evolution of minimally invasive temporomandibular joint surgery, summarizes the current status of MIS applications in ADDwoR, and discusses future directions. It aims to provide a reference for further promoting and implementing MIS concepts in the treatment of TMDs.
Sichuan Provincial Medical Association Medical Aesthetics and Cosmetology Specialty Committee
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297612
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This consensus systematically addresses the unique facial anatomical and aging characteristics of the population in Southwest China and systematically proposes an individualized injection protocol for botulinum toxin typ...This consensus systematically addresses the unique facial anatomical and aging characteristics of the population in Southwest China and systematically proposes an individualized injection protocol for botulinum toxin type A (BONT/A) for upper and mid-face aesthetic treatments. The protocol was tailored to the skeletal and muscular features of this regional group and incorporates precise injection techniques, dosage recommendations, and depth guidance for key upper facial areas, such as forehead lines, glabellar lines, crow's feet, nasal wrinkles, and temporalis muscle. In addition, it outlines peri‑injection assessment procedures, combined treatment strategies, and the management of adverse reactions. The aims are to provide clinicians with standardized operational guidance that aligns with regional characteristics and to enhance the safety, precision, and aesthetic outcomes of treatment.
Expert Group of “Expert Consensus on the ‘Four-Level and Dual-Axis’ Comprehensive Diagnostic and Therapeutic System for Prosthetic Rehabilitation of Oral Diseases”
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297611
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Traditionally, prosthodontics has adhered to a clinical diagnosis and treatment model centered on "tooth defects, partial edentulism, and complete edentulism", which show insufficient alignment with the modern "biopsycho...Traditionally, prosthodontics has adhered to a clinical diagnosis and treatment model centered on "tooth defects, partial edentulism, and complete edentulism", which show insufficient alignment with the modern "biopsychosocial" medical model. The demand of high-quality medical services continues to increase with the nation's growing prosperity and the continuous extension of average life expectancy. Facing these heightened medical demands, particularly the challenges of oral frailty and multimorbidity in an aging society, the traditional diagnostic and therapeutic system for prosthodontics increasingly reveals limitations, including insufficient information coverage, obscuring the underlying etio-logy, the neglect of individual psychological needs, and a lack of holistic consideration for multimorbidity. This consensus proposes the "Four-Level and Dual-Axis" comprehensive diagnostic and therapeutic system for prosthetic rehabilitation of oral diseases to address these bottlenecks in disciplinary development. This system classifies the diagnostic scope from micro to macro into four functional levels of "tooth-pulp", "dentition-occlusion", "occlusion-temporomandibular joint", and "maxillofacial-systemic" emphasizing the pathological cascade reactions between levels and a bidirectional diagnostic logic. Simultaneously, it introduces a subjective-objective dual-axis assessment model comprising "individual psychology and prosthetic needs (axis A)" and "etiology and patho-anatomical diagnosis (axis B)," achieving an integration of medical rationality and humanistic care. By reconstructing diagnostic logic and implementing standardized sequential treatment pathways, this consensus aims to facilitate the continuous transition of prosthodontics toward the "biopsychosocial" medical model, shifting from a "prosthesis-centered" approach to a "patient-centered and disease-focused" model of precision personalized prosthetic rehabilitation.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297610
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Endodontic microsurgery, a highly effective intervention for complex periapical lesions, is performed to achieve true regeneration of periapical soft and hard tissues, including alveolar bone, periodontal ligament, and c...Endodontic microsurgery, a highly effective intervention for complex periapical lesions, is performed to achieve true regeneration of periapical soft and hard tissues, including alveolar bone, periodontal ligament, and cementum. In recent years, various tissue regeneration strategies and prominently guided tissue regeneration have been integrated into endodontic microsurgery to enhance success rates and optimize defect healing. In this article, the necessity and clinical impact of employing tissue regeneration techniques across diverse endodontic microsurgery cases are evaluated by through a systematic literature review. Existing evidence demonstrates that these techniques significantly improve success rates in challenging scenarios such as large lesions, through-and-through lesions, and apical-marginal defects. In the future, relevant technical standards and clinical guidelines based on more high-quality clinical evidence must be urgently established to standardize the application of tissue regeneration techniques in microsurgical root canal therapy.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297609
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The application of endodontic microsurgery in complex cases is often limited by difficulties in apex localization due to complex anatomical structures. The introduction of digital technologies has provided a novel approa...The application of endodontic microsurgery in complex cases is often limited by difficulties in apex localization due to complex anatomical structures. The introduction of digital technologies has provided a novel approach to address this challenge. This article reviews the operational workflows, clinical application points, accuracy, key influencing factors, and clinical application considerations of static navigation, dynamic navigation, and robotic system assistance in endodontic microsurgery. Clinical cases are presented to demonstrate the successful application of digital technologies in managing complex endodontic microsurgeries, providing references for clinicians performing such cases. Furthermore, the future direction of digital technologies in endodontic microsurgery toward intelligence, standardization, and minimally invasive development is discussed.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297608
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The posterior maxillary region presents substantial challenges in endodontic microsurgery owing to its unique anatomical position and intricate root canal anatomy. Three factors contribute to this complexity: first, the...The posterior maxillary region presents substantial challenges in endodontic microsurgery owing to its unique anatomical position and intricate root canal anatomy. Three factors contribute to this complexity: first, the posterior location and limited surgical field, compounded by prominent buccal and palatal contours, severely limit visual clarity and operative maneuverability. Second, the complex root canal anatomy‒particularly isthmuses and the second mesiobuccal canal‒increases the difficulties and risks associated with root-end resection and retrograde obturation. Third, the intimate proximity of root apices to the maxillary sinus floor poses substantial risks of sinus membrane perforation and subsequent complications. To address these challenges, we propose a systematic analytical approach and refine operational strategy throughout the entire surgical procedure, aiming to thoroughly eliminate the source of infection, achieve reliable apical sealing, maximize tooth structure preservation, and ensure the safety of adjacent critical structures. This study systematically analyzes the three major challenges and offers corresponding surgical strategies and recommendations for risk prevention and control, to standardize practice and improve treatment outcomes in maxillary posterior endodontic microsurgery.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297607
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Endodontic microsurgery is a critical treatment option that is often considered when conventional root canal therapy fails or when complex periapical diseases cannot be resolved through non-surgical treatment. The clinic...Endodontic microsurgery is a critical treatment option that is often considered when conventional root canal therapy fails or when complex periapical diseases cannot be resolved through non-surgical treatment. The clinical outcomes of endodontic microsurgery are influenced by multiple factors. Among these, the size of the periapical lesion is considered a key variable that can significantly impact surgical design, operative difficulty, postoperative infection control, and tissue healing. This article systematically discusses the mechanisms by which the size of periapical lesions affects the efficacy of endodontic microsurgery, preoperative assessment methods, intraoperative management strategies, and prognostic correlations. On the basis of existing evidence from evidence-based medicine, clinical management re-commendations are proposed to provide a theoretical foundation and operational guidance for clinical practice.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297606
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With the development of microsurgical endodontic techniques, their clinical application is gradually expanding. As a critical component, soft tissue management significantly affects surgical outcomes, especially because...With the development of microsurgical endodontic techniques, their clinical application is gradually expanding. As a critical component, soft tissue management significantly affects surgical outcomes, especially because many cases involve the aesthetic zone of anterior teeth. Balancing aesthetic and functional restorations aligns with mo-dern dental principles. In this article, the key points in soft tissue management during microsurgical endodontics were systematically outlined, covering flap design principles, preoperative assessment, operative techniques, and the management of a particularly challenging issue, that is, chronic periapical lesions combined with soft tissue fenestration. This work aims to enhance clinicians' understanding of soft tissue handling in microsurgical endodontics and improve clinical treatment standards.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297605
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As dental technology advances, apical microsurgery has emerged as a vital therapeutic approach for preserving natural teeth following unsuccessful root canal treatment or nonsurgical endodontic retreatment. Its clinical...As dental technology advances, apical microsurgery has emerged as a vital therapeutic approach for preserving natural teeth following unsuccessful root canal treatment or nonsurgical endodontic retreatment. Its clinical application is becoming increasingly widespread, but the careful selection of surgical indications is crucial for ensuring treatment efficacy and improving the prognosis of affected teeth. This paper synthesizes existing research and clinical experience to outline core assessment criteria for surgical selection, thereby providing a reference framework for clinicians to standardize the conduct of apical microsurgery and optimize treatment decision-making.
Tan X, Peng L, Su Q
… +7 more, Xu X, Yang J, Song D, Wang C, Zhang L, Ye L, Huang D
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Jun · PMID 42297604
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Endodontic microsurgery (EMS) can handle challenging endodontic cases effectively. However, the complexity and postoperative outcome of EMS are closely related to multiple factors such as the patient's general condition,...Endodontic microsurgery (EMS) can handle challenging endodontic cases effectively. However, the complexity and postoperative outcome of EMS are closely related to multiple factors such as the patient's general condition, the affected tooth, and the surrounding anatomical structures. This article draws on international and domestic medical standards, including the American Society of Anesthesiologists, the American Association of Endodontists, the World Health Organization, and the expert consensus on the assessment of root canal treatment difficulty in China. Based on the basic principles, procedures, and anatomical data of EMS, combined with long-term clinical experience, clinical epidemio-logy, and evidence-based medicine, this article analyzes the difficult and complex factors of EMS cases. This work aims to provide references for treatment decisions, doctor-patient communication, application and promotion, clinical tea-ching, and hierarchical referral in EMS.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Apr · PMID 41919550
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The removal of a full crown typically requires considerable chairside time, and the interface between zirconia and resin cement in zirconia restoration is difficult to discern. A high-speed dental handpiece may damage re...The removal of a full crown typically requires considerable chairside time, and the interface between zirconia and resin cement in zirconia restoration is difficult to discern. A high-speed dental handpiece may damage residual dental tissue, thereby affecting the final outcome. The article presents a case after a restoration involving a fiber post, resin core, and zirconia full crown. For esthetic purposes, the removal of the full crown is necessary. An Er:YAG laser was used to completely remove the intact crown, which was then used as temporary restoration. A satisfactory esthetic result was attained after the final restoration. The case suggests that crown extraction with an Er:YAG laser is a safe and effective technique.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Apr · PMID 41919549
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Conventional submandibular gland resection is typically performed via a lateral cervical open approach, which inevitably leaves a visible scar. As a leading advancement in minimally invasive techniques, robotic-assisted...Conventional submandibular gland resection is typically performed via a lateral cervical open approach, which inevitably leaves a visible scar. As a leading advancement in minimally invasive techniques, robotic-assisted surgery shows significant potential for clinical application. To date, only a limited number of robot-assisted submandibular gland resections have been reported globally, and most were conducted using the Da Vinci Surgical System. No cases involving a domestically developed Chinese robotic system have been documented in either domestic or international lite-rature. Using nearly 100 cases of endoscopic submandibular gland resection through retroauricular hairline approach as basis, we successfully performed three cases of submandibular gland resection with the assistance of a domestically developed multi-arm universal surgical robot. All procedures were completed without intraoperative conversion. Postoperative recovery was uneventful, with no complications including facial nerve palsy, tongue numbness, or impaired tongue mobility. The incisions were well concealed, achieving satisfactory aesthetic outcomes. This preliminary study demonstrates the feasibility of utilizing a Chinese-developed robotic system for submandibular gland resection.
Hua Xi Kou Qiang Yi Xue Za Zhi
· 2026 Apr · PMID 41919548
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OBJECTIVES: By comparing deep learning and habitat analysis models based on contrast-enhanced CT (CECT), this study explores a novel approach to predict cervical lymph node metastasis and pathological subtypes in oral sq...OBJECTIVES: By comparing deep learning and habitat analysis models based on contrast-enhanced CT (CECT), this study explores a novel approach to predict cervical lymph node metastasis and pathological subtypes in oral squamous cell cancer (OSCC). METHODS: CECT images from patients diagnosed with OSCC by paraffin pathology were retrospectively collected. A total of 107 patients underwent primary lesion resection and cervical lymph node dissection. Region-of-interest images under CECT were divided into three regions using K-means clustering, and feature selection was performed through a fully connected neural network to construct a habitat analysis model. A clinical model was constructed using nine clinical features, including age, gender, and tumor location. With pathological subtypes and lymph node metastasis (LNM) as study endpoints, the predictive capabilities of the clinical model, deep learning model, habitat analysis model, and combined clinical + habitat model were compared using confusion matrices and receiver operating characteristic (ROC) curve. RESULTS: The habitat-clinical combined model exhibits superior predictive performance: in the prediction of lymph node metastasis, the area under the receiver operating characteristic curve (AUC) reaches 0.97. In the prediction of pathological typing, the AUC values are 1.00 for well-differentiated type, 0.94 for moderately differentiated type, and 1.00 for poorly differentiated type. This combined model outperforms the standalone clinical and habitat models in predicting pathological typing and lymph node metastasis. CONCLUSIONS: The habitat-clinical integrated model exhibits superior predictive efficacy in evaluating LNM and pathological classification in oral carcinoma.