Lingual nerve injury is one of the serious complications in alveolar surgery, which often occurs after the extraction of the mandibular third molar (M3M), with the incidence varying from 0.1% to 22%.Due to the limitations of clinical and conventional radiographical examinations, some severe cases do not receive accurate diagnosis and effective treatment in the early stage of injury, resulting in permanent lingual nerve injury and consequent impact on the quality of life. In recent years, magnetic resonance neurography (MRN) has been gradually used in the examination of nerve injury, and several new MRN sequences have reasonable visualization of severe lingual nerve injury, making early diagnosis and therapy possible. This article reported a patient with lingual nerve injury caused by the removal of M3M for 2 weeks, and complete disconnection of the affected lingual nerve was clearly visualized through MRN. Subsequently, a nerve anastomosis surgery was performed, and the disconnection was observed during the operation, proving the consistency of the MRN imaging and the fact. Postoperative follow-up showed gradually functional recovery of the lingual nerve.
As a traditional Chinese medicinal material, common bletilla rubber is widely distributed, cheap and easy to obtain. With the development of traditional Chinese medicine, common bletilla rubber is widely used in the treatment of bacterial infection, tumor, digestive tract ulcer, gastric mucosal lesions, external blood and so on. In this article, the pharmacological properties and chemical components of common bletilla rubber were summarized, and the mechanisms and pathways of each ingredient of common bletilla rubber were also analyzed. The application of common bletilla rubber in the field of oral diseases, including oral mucosal diseases, caries, intramedullary barrier materials and periodontal tissue engineering scaffold materials were summarized. It was proved that common bletilla rubber could play an important role in the fields above, no matter which form it was in. This article may provide reference for the further promotion of common bletilla rubber in the treatment of oral diseases.
Periodontitis and diabetes are common diseases in clinic, which have a huge impact on the health and life of patients. In recent years, it was proven that these two diseases have a strong correlation, so drugs for treating periodontitis and diabetes have also become a research hotspot. Resveratrol is a kind of polyphenol compound from natural plants, which has anti-inflammatory, antioxidant, lipid lowering and metabolic regulating effects. At the same time, it also has the advantages of small toxic side effects, wide access, low price, etc. It is a kind of auxiliary antibacterial drug with great potential in the treatment of periodontitis and diabetes, and also a new way to solve the problem of bacterial resistance in chronic inflammatory diseases. This article reviewed the new progress of resveratrol in the treatment of periodontitis and diabetes in recent years, in order to provide new ideas for its further research and application.
Children with dental phobia are very common in clinics, and it is usually not possible to complete oral treatment through conventional methods for these children. By promoting tooth remineralization and isolating the nutrition supply of cariogenic bacteria, interim treatment can restrain the progress of caries to a certain extent, and gain time for further treatment of deciduous teeth and normal replacement of permanent teeth. It is safe, simple and economical, such that it is expected to become an alternative treatment that is more easily accepted by children and parents. This article reviewed the research advances of several interim treatment methods for deciduous tooth caries.
Objective:To explore the clinical therapeutic effect of additive manufacturing Ti-6Al-4V titanium alloy implants in dental implant restoration.Methods:Retrospective analysis was conducted on 86 patients with posterior tooth loss treated in the Department of Stomatology, the Fifth Affiliated Hospital, Sun Yat-sen University, and the Department of Dental Implantation, the Affiliated Hospital of Guangxi Medical University from November 2020 to June 2022, with a total of 87 missing teeth. Among them, there were 43 cases in the test group, with 44 missing teeth, which were restored with Ti-6Al-4V titanium alloy implants made of self-developed additives. In contrast, another 43 cases in the control group, with 43 missing teeth, were restored with B & B implants (Italy) . The implant success rate, changes in bone tissue around the implant, gingival status, and chewing efficiency within six months after implantation were compared between the two groups with SPSS 23.0 at a significance level of 0.05.Results:In the test group, there was no implant loss, no redness or swelling of the gingiva, and the chewing function was normal after restoration. Two cases showed marginal bone loss, with a success rate of 95.5%. In the control group, two implants failed, and one case had a repeated loose of the abutment screw. The implant success rate was 93%, and there was no statistically significant difference in the success rate between the two groups (χ2 = 0.237, P>0.05) ; The test group had no occlusal interference and food impaction after implant denture restoration, with good chewing function and a total effective rate of 100%. In the control group, one case had poor chewing function due to loose screw, with a total effective rate of 97.7%. There was no statistically significant difference in chewing function (χ2 = 0.181, P>0.05) . The bone resorption around the implant was less than 0.6 mm at each follow-up time point in both the two groups, with no significant difference between them (t = 1.974, P>0.05) . Patient satisfaction with the restoration was 93.2% in the test group and 95.3% in the control group, which was not statistically different (χ2 = 0.236, P>0.05) .Conclusions:Additive manufacturing Ti-6Al-4V titanium alloy implant has achieved satisfactory short-term clinical outcomes in terms of success rate, chewing function and aesthetic effect in the restoration of missing posterior teeth, which can be applied clinically. However, its long-term clinical effect needs to be further observed.
Based on the reports of the previous Workshops in 2017 and 2019, the third joint Workshop by the European Federation of Periodontology (EFP) and the European arm of the World Organization of Family Doctors (WONCA) (2022) discussed and summarized the associations between periodontitis and cardiovascular diseases, diabetes and respiratory diseases, and the implications for dentists and family doctors. The role of dentists and family doctors in managing non-communicable diseases and promoting healthy lifestyles was discussed as well. This article briefly introduced the main content of this Workshop and explored the enlightenments about multiple disciplinary team treatment combining with the national conditions of China.
Objective:To analyze and summarize the treatment experiences of surgical treatment combined with oral sirolimus for lymphatic malformations (LM) in children′s oral and maxillofacial region.Methods:Medical records and imaging data of children diagnosed with LM in oral and maxillofacial region admitted to the oral and maxillofacial surgery ward of Guangzhou Women and Children′s Medical Center from January 2019 to December 2022 were collected. The patients′ information, therapeutic effect of the first treatment, therapeutic effect between different types of classification, and sirolimus-induced adverse drug reactions in pediatric patients were analyzed, and a literature search was conducted.Results:A total of 14 patients were treated with sirolimus for the first time, and none of them had complete remission (CR) . Partial response (PR) accounted for 64.29% (nine cases) , all of them were mixed LM, and none were microencapsulated LM. No response (AR) accounted for 35.71% (five cases) , and all the three microencapsulated LM cases were AR. Surgical resection was selected for the first treatment of one case, and basically returned to the normal form and function, and it was evaluated as CR. One of the 15 patients was diagnosed as suspected sirolimus-induced adverse drug reactions of sirolimus with repeated fever and pulmonary infection.Conclusions:Sirolimus can be used as an option in the management of LM patients with life-threatening upper airway. The drug has limitations in the treatment of LM and needs to be combined with other treatments to improve the therapeutic effect. Sirolimus is not recommended as the first choice for microencapsulated LM without obvious symptoms. The sirolimus-induced adverse drug reactions caused by sirolimus was not related to age, but it showed dose correlation. The younger the age, the lower the dose. Close monitoring of blood concentration and timely dose of sirolimus could reduce the occurrence of sirolimus-induced adverse drug reactions. The treatment of LM still requires surgeons to develop individualized sequential treatment regimens for each patient.
Tertiary lymphoid structures (TLSs) are organized aggregates of immune cells that form postnatally in nonlymphoid tissues. TLSs are not found under physiological conditions but arise in the context of chronic inflammation, such as autoimmune diseases, chronic infection, and cancer. In the setting of cancer development, TLSs facilitate the influx of immune cells into the cancer site and have therefore attracted interest as a means of improving anticancer immunity and favorable treatment response in patients. In spite of their presumed importance, the drivers of TLSs formation in cancer and the contribution of these structures to intratumoral immune response remain incompletely understood. In this article, the biology of TLSs and their recent advances in oral cancer research were reviewed.
Objective:To investigate the origin, clinical characteristics, imaging diagnosis and treatment of Stafne bone cavity (SBC) in order to reduce the misdiagnosis and missed diagnosis of the SBC.Methods:Retrospective analysis was made on the clinical manifestations, imaging characteristics and treatment plans of 10 cases of SBC treated in Oral and maxillofacial surgery of the Affiliated Hospital of Qingdao University from February 2018 to October 2022. A total of 10 patients with similar age, location and shape of SBC who had taken CBCT in the same period in the hospital and were confirmed as mandibular apical cysts by pathology were selected with the random number table method. Statistical analysis was done with SPSS 22.0 The HU values of SBC and mandibular apical cysts in cone-beam computed tomography (CBCT) were compared at a significance level of 0.05. Finally, combined with a literature search, we summarized the possible causes, clinical diagnosis and treatment plans.Results:According to the clinical manifestations and imaging results, nine of the 10 patients with Stafne bone cavity were located in the posterior part of the mandibular body, and one was located in the mandibular ramus. None of the 10 patients had pain, swelling, abnormal physiological function and other symptoms, so they did not receive treatment and were closely followed up. The difference of HU value between Stafne bone cavity and mandibular apical cyst was statistically significant [ (HUSBC = -86 (-113, -78) , HUapical cyst = 19 (-12, 37) , Z = -3.311, P<0.001].Conclusions:Stafne bone cavity is a relatively rare bone cavity occurring in the mandible. Due to its location and imaging particularity, clinical attention should be paid to it, and the corresponding examination methods should be combined to reduce the occurrence of misdiagnosis and missed diagnosis. The HU value of CBCT can be used as an auxiliary means to identify Stafne bone cavity, which is worthy of clinical promotion.
Objective:To investigate the molecular mechanism of inflammatory response in human periodontal ligament cells (hPDLCs) under inflammatory conditions.Methods:Vimentin and keratin were identified by immunofluorescence. hPDLCs were stimulated with different concentrations (0, 0.1, 10, 100 μmol/L) of lipopolysaccharide (LPS) , and apoptosis was detected by flow cytometry. The expression of hyaluronan receptor CD44 in cell culture supernatant was detected by enzyme-linked immune sorbent assay (ELISA) after the LPS stimulation. The expression of CD44 and matrix metalloproteinase (MMP) -14 in the cytoplasm and nucleus of hPDLCs in inflammatory environment was detected by ELISA, Western blot and cell immunofluorescence. The expression of inflammatory factors was detected by Cytometric Bead Array (CBA) . Furthermore, MMP-14 and Importin β inhibitor were added in the inflammatory environment, and the expression of CD44 and interleukin-6 (IL-6) mRNA was detected by ELISA and RT-PCR, respectively.Results:LPS did not affect the apoptosis of hPDLCs at different concentrations (0.1, 1, 10, 100 μmol/L) . After 4 h stimulation with 1 μmol/L LPS, the fluorescence intensity of MMP-14 in hPDLCs significantly increased (233.75) , while that in control group was 107.53, and the difference was statistically significant (t = 10.10, P<0.001) . CD44 fluorescence intensity was 106.7 in the LPS group and 84.58 in the control group, and the difference was statistically significant (t = 3.13, P = 0.02) . MMP-14 inhibitor could significantly inhibit the expression of CD44 in cell culture supernatant, and the expression of CD44 in the LPS+MMP-14 inhibitor group was significantly lower than that in the LPS group, and the difference was statistically significant (t = 5.03, P = 0.001) . LPS stimulation of hPDLCs increased the expression of CD44 and Importin β in the nucleus, and the difference was statistically significant (P<0.001) . After LPS stimulation, the expression of CD44 and Importin β in the nucleus was also up-regulated. LPS increased the expression of IL-6, and the difference was statistically significant (P<0.001) , and the expression of IL-6 mRNA in the cells treated with LPS plus Importin β inhibitor was significantly lower than that in the LPS treatment group. The differences were statistically significant (t = 16.79, P<0.001) .Conclusions:LPS can up-regulate the expression of CD44, Importin β and IL-6 in hPDLCs. MMP-14 and Importin β inhibitor can inhibit the nuclear translocation of CD44 and the up-regulated expression of IL-6 in inflammatory environment. These results suggested that MMP-14 and CD44 participated in the inflammatory response of hPDLCs under inflammatory conditions, and CD44 can transfer to the nucleus and mediate the release of IL-6.
Chronic kidney disease (CKD) is one of the common clinical urinary diseases, and its incidence rate has been increasing in recent years, such that it has become a major public health problem in the world. Periodontitis is a highly common oral disease in the middle-aged and elderly people, which is the main cause of tooth loss in adults and closely related to the occurrence and development of various diseases. In recent researches, it has been suggested that the main pathogen of periodontitis, Porphyromonas gingivalis (P.g) , may be an important risk factor of CKD. People suffering from both periodontitis and CKD had worse kidney fucntion than those with CKD only, and the kidney function of the former could be improved by periodontal treatment. It was found in several studies that P.g played an important role in the occurrence and development of CKD in a variety of ways, including destroying the integrity of the renal epithelium, aggravating the inflammatory response and the oxidative stress damage of kidney tissue. This article systematically reviewd the relevant studies of P.g in the occurrence and development of CKD, so as to obtain a comprehensive understanding of the relationship between periodontitis and CKD as well as the related pathogenic mechanism.
An immediate maxillary obturator prosthesis was designed and fabricated by digital technologies for a patient with maxillary osteonecrosis secondary to the myelodysplastic syndrome before maxillectomy in order to reconstruct the oral function and facial appearance after the surgery. The patient′s oral function and appearance were improved significantly by the prosthesis. The digital technologies to design and fabricate the prosthesis used in this case could be effectively applied to the immediate reconstruction of maxillary defects with high efficiency and satisfactory outcome.
Caries and periodontal disease are common oral diseases closely related to dental plaque. Effective plaque control is the key to maintain the health of teeth and periodontal tissue. Toothbrushing is an effective personal plaque control method. Improving the design of toothbrush plays an important role in increasing its plaque removal efficiency and safety. This article reviewed the effects of different designs on the performance of toothbrushes.
Objective:To explore the cognitive status of periodontal medicine (the relationship between periodontal and systemic diseases) among undergraduates of stomatology and provide reference for the teaching reform of periodontology.Methods:On February 2021, a total of 254 undergraduates from Grade 2017 to 2020 in the School of Stomatology in a medical university in Guangdong Province were selected. Students′ basic cognition, analysis and application ability (the relationship between periodontal disease and hospital infection, ethics, etc.) of periodontal medicine were investigated by questionnaire. Analysis of variance and other methods were used to compare the ability differences between different grades.Results:A total of 154 valid questionnaires were recovered (73 males, 81 females, recovery rate 60.63%). The scores of Grades 2020, 2019, 2018, and 2017 were 34 ± 9, 42 ± 6, 45 ± 7, and 43 ± 6 (out of 64), respectively, which were significantly different between grades (F = 17.737, P<0.001). The gap was mainly in the basic cognitive ability of periodontal medicine (out of 44), and the score of Grade 2020 was 6-9 points lower than that of the other three grades (P<0.001). In terms of analysis ability (out of 15) and application ability (out of 5), the scores of the four grades were not more than 60% of the full score, and there was no significant difference between grades.Conclusions:Undergraduates who had the theoretical course of periodontology got the basics of periodontal medicine, but lacked deep understanding and application ability. The hospital infection prevention and control, and the systematic clinical thinking need to be strengthened in the periodontology teaching.
Objective:The recombinant adenovirus of p38 mitogen-activated protein kinases (p38MAPK) gene was used to knock down the expression of target genes. By detecting the influence of p38MAPK signal pathway obstruction on upper lip scar hyperplasia in different time periods, the optimal therapeutic time of gene therapy was determined.Methods:A total of ninety New Zealand white rabbits with cleft upper lip of 2.0-2.5 kg were treated with cleft lip repair. Recombinant virus was injected into the scar center at week 0, 1 and 2 after surgery, and the scar tissue was made into specimens at week 3 after surgery. Western blot, Real-time fluorescence quantitative RT-PCR and immunohistochemical staining were used to quantitatively and qualitatively detect the relative expression levels of proteins and mRNA of p38MAPK, scar formation related factors and Smad. The results of Western blot and RT-PCR were analyzed with software (SPSS v. 24.0) .Results:The results of Western blot, RT-PCR and immunohistochemical staining showed that the expressions of Col Ⅲ (1.373 ± 0.073, F = 8.027, P = 0.002) and MMP1 (1.715 ± 0.028, F = 9.262, P = 0.001) in scar tissue of the injection group at week 1 after surgery were significantly higher than those at week 0 and 2. The expressions of ColⅠ (0.424 ± 0.015, F = 7.794, P = 0.003) and TIMP1 (0.464 ± 0.025, F = 6.196, P = 0.007) significantly decreased. The expression level of Smad protein and mRNA in the injection group at 1 week after surgery decreased, and the results were statistically significant compared with other groups (Fp-smad2 = 14.123, Pp-smad2 = 0.029; Fp-smad3 = 3.796, Pp-smad3 = 0.037) .Conclusions:Inhibition of p38MAPK expression may play a role in inhibiting scar hyperplasia through the Smad dependent signaling pathway. Targeted p38MAPK knockdown had the greatest effect on scar hyperplasia at one week after cleft-lip surgery in rabbit upper lip.
With the development of aging, multimorbidity has become increasingly prominent, and its association with oral health has gradually attracted attention. Oral health is a good predictor of multimorbidity. This paper aims to review the research progress based on the association and statistical methods, and clarify further research emphasis. Compared with studies abroad, Chinese researchers pay insufficient attention to the association between oral health and multimorbidity. Regarding research content, current research focuses on simple association between oral health and multimorbidity, and has not yet established a consensus on multimorbidity, nor explored an in-depth association between oral health and multimorbidity. As to statistical methods, the majority research is based on regression analysis or logistic regression, and less is used for cutting-edge statistical analysis methods. In the future, it is necessary to establish a consensus on multimorbidity, use clustering or other methods to explore the multimorbidity, further use cutting-edge machine learning and deep learning technologies to explore the association between oral health and multimorbidity, analyze its pathogenesis, and provide an evidence-based basis for the formulation of oral-centered interventions.
Implant is one of the key materials in the implant treatment process. Subtractive manufacturing is the main mode of production for implants. In recent years, the emergence and development of metal three-dimensional (3D) printing technology have provided an alternative method for the manufacturing of dental implants. Powder bed melting is one of the metal 3D printing technologies and most widely used in the biomedical field. Among them, selective laser melting (SLM) is the mainstream process of powder bed melting, which has strong comprehensive properties and broad application prospects. It has been found that 3D printing titanium implants have better mechanical properties than castings and are close to forgings, but there is a problem with mechanical properties anisotropy that needs to be optimized to meet the requirements of dental implant materials. In terms of biological characteristics, it has been proved that 3D printing technology does not affect the biocompatibility of titanium materials. Researchers demonstrated that 3D printed titanium implants have similar or even better osseointegration properties than the conventional titanium implants in three aspects: healthy animals, disease animal models and human experiments. Finally, the problems existing in 3D printed titanium implants are summarized and further research is envisioned.
Objective:To investigate the effect of dexmedetomidine combined with ropivacaine on postoperative pain, nausea and vomiting in adult female patients undergoing temporomandibular joint surgery.Methods:A total of 75 female patients aged 18 to 43 years who underwent temporomandibular joint surgery were included in Shenzhen Stomatological Hospital from January to December 2021. They were randomly divided into the study group (38 cases) and control group (37 cases). After general anesthesia intubation, 20 mL 0.5% ropivacaine + 2 mL 2.0 μg/kg dexmedetomidine were used in the study group, and 5% ropivacaine + 2 mL normal saline were used in the control group for local infiltration anesthesia in the operation area. The main outcome measures of the two groups were recorded: postoperative nausea and vomiting (PONV) and frequency. The secondary outcome indicators included postoperative pain score (VAS) at 4 h, 8 h and 24 h, effective pressing times of analgesic pump, relative time and hemodynamic indicators. Comparative analysis was done by using two independent samples t-test and Fisher′s accurate test in software (SPSS, v. 22.0) .Results:1. PONV: The PONV rate of the study group (13.2%) was lower than that of the control group (40.5%) (χ2 = 7.188, P = 0.007) ; The frequency of vomiting in the study group (0.18 ± 0.563, times) was lower than that in the control group (1.60 ± 2.46, times), which was statistically significant (t = -3.451, P = 0.001). 2. Postoperative pain: The VAS scores at 4 h, 8 h and 24 h after operation in the study group were 2.1 ± 0.9, 2.3 ± 0.6 and 1.5 ± 0.6, respectively, which were lower than those in the control group (3.1 ± 0.8, 4.7 ± 0.8 and 2.5 ± 1.2). The differences were statistically significant (t4 h = -4.971, t8 h = -14.913, t24 h = -4.471, P<0.001). The pressing times of the study group[ (2.11 ± 1.47) times] were significantly lower than those of the control group[ (8.84 ± 1.94) times], which was statistically significant (t = -17.001, P<0.001). 3. Hemodynamic indexes: There was no significant difference in systolic blood pressure between the two groups at the time of entry, 1 h after entry and exit (tentry = -1.870, Pentry = 0.066, tentry 1 h = -1.583, Pentry 1 h = 0.118, texit = -1.805, Pexit = 0.075) ; The diastolic blood pressure in the control group (59 ± 9) mmHg was higher than that in the study group[ (55 ± 4) mmHg; 1 mmHg = 0.133 kPa], which was statistically significant (t = -2.249, P = 0.028). There was no statistical difference between the two groups in the rest of the timepoints.Conclusions:Dexmedetomidine combined with ropivacaine for local infiltration anesthesia in adult female patients undergoing temporomandibular joint surgery can reduce the incidence of nausea and vomiting, improve the postoperative analgesic effect and prolong the analgesic time, which is worthy of clinical promotion.
Objective:To study the regularity of the delayed wound healing after cleft palate repair.Methods:From April 2017 to December 2019, a total of 150 patients with delayed wound healing after primary cleft palate repair were included in the Department of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University. The changing regularity and influencing factors of delayed wound healing within 6 months after cleft palate repair were analyzed.Results:When the sites of delayed wound healing occurred at the hard palate, the junction of hard and soft palate, and the soft palate, the final formation of palatal fistula accounted for 38.1%, 9.8% and 6.7%, respectively, of the total number of delayed wound healing cases at each site, and the differences were statistically significant (χ2 = 52.962, P<0.001). When the wound areas of delayed wound healing were ≤0.5 cm2, >0.5-≤1.0 cm2, >1.0-≤1.5 cm2 and >1.5 cm2, the final formation of palatal fistula accounted for 5.6%, 14.8%, 35.8% and 44.9%, respectively, of the total cases of each wound area, and the differences were statistically significant (χ2 = 28.068, P<0.001). There was no difference in other related factors such as age, gender and cleft palate type.Conclusion:Delayed wound healing after primary cleft palate repair may be correlated to the sites and size of the wound.
Objective:This study was to develop a retention force measuring system and evaluate its performance.Methods:A retention force measuring system was designed with three parts: retention force measuring instrument, clamp dynamometer, and retention force measuring software system. Main indicators included the measuring range from 0 to 50 N and the continuous measurement which collected 1 000 valid data per second. Then accuracy measurement experiment of the system was conducted using weights. Next, 12 CoCr and 12 CP-titanium clasps fabricated by additive manufacturing. The clasps made from the same material were labeled from 1 to 12, and 12 corresponding random numbers were generated and sorted in a descending order using Excel software. The first six clasps in the list were to form a group. The clasps of each material were divided into two groups (n = 6) , and their initial retention forces were measured using two methods. The obtained results were statistically analyzed using SPSS 18.0. One-Way ANOVA was used to compare the system precision, and independent sample t-test was performed to compare the initial retention force of denture clasps obtained by different measurement methods.Results:The accuracy of the developed retention force measurement system complied with the design requirements. There was significant difference in the initial retention forces of clasps between the universal material testing machine [CP-titanium: (13.96 ± 1.51) N, CoCr: (18.93 ± 1.42) N] and the retention force measurement system [CP-titanium: (10.35 ± 0.75) N, CoCr: (15.34 ± 0.68) N] (tCPTi = -11.740, PCPTi<0.001; tCoCr = -12.492, PCoCr<0.001) .Conclusion:The measurement system developed in this study revealed a more reliable retention force change in the process of clasp dislocation, which was closer to the clinical situation.
