PURPOSE:To evaluate the clinical effect of stromal cell-derived factor 1α(SDF-1α)combined with platelet-rich fibrin(PRF)in the treatment of permanent tooth avulsion.METHODS:A total of 72 patients(78 affected teeth)with permanent tooth avulsion who were admitted from April 2022 to January 2024 were selected and divided into the experi-mental group(36 cases,40 affected teeth)and the control group(36 cases,38 affected teeth)by random number table method.Both groups of patients underwent replantation treatment,after alveolar socket preparation,the control group was filled with PRF,and the experimental group was filled with PRF combined with SDF-1α.The success rate of replantation,postoperative occlusal pain,levels of growth factors[vascular endothelial growth factor(VEGF),platelet-derived growth factor(PDGF),transforming growth factor beta(TGF-β),fibroblast growth factor(FGF)],inflammatory factors[soluble inter-cellular adhesion molecule 1(sICAM-1),interleukin 6(IL-6),C-reactive protein(CRP)]and complications were compared between the two groups.RESULTS:The replantation success rate of the experimental group was 100.00％(40/40),signif-icantly higher than that of the control group,which was 89.47％(34/38)(P＜0.05).One week,one month,six months and twelve months after treatment,the pain degree scores of the two groups gradually decreased(P＜0.05).One week and one month after treatment,the pain degree score of the experimental group was significantly lower than that of the control group(P＜0.05).At 6 months and 12 months after treatment,there was no significant difference in the pain degree scores between the two groups(P＞0.05).After treatment,the levels of VEGF,PDGF,TGF-βand FGF in both groups were signifi-cantly higher than those before operation,and the experimental group was significantly higher than the control group(P＜0.05).After treatment,sICAM-1 in both groups was significantly higher than that before operation(P＜0.05),IL-6 and CRP were significantly lower than those before operation(P＜0.05).The postoperative sICAM-1 in the experimental group was significantly higher than that in the control group(P＜0.05),and the levels of IL-6 and CRP were significantly lower than those in the control group(P＜0.05).There was no significant difference in the incidence of postoperative complications be-tween the two groups.CONCLUSIONS:Treatment of permanent tooth avulsion with SDF-1α combined with PRF can im-prove the replantation success rate of avulsed teeth,reduce postoperative pain responses,with good efficacy and safety.
PURPOSE:To evaluate the diagnostic value of a random forest(RF)algorithm based on CBCT features of the condyle for staging idiopathic condylar resorption(ICR).METHODS:A total of 120 patients with ICR admitted to Nanjing Stomatological Hospital from January 2016 to December 2024 were selected and divided into the stationary phase group(n=70)and the progressive phase group(n=50).Healthy individuals who underwent physical examinations during the same period(n=40)were selected as the control group.The CBCT features of condylar length,inner 1/3 width,middle 1/3 width,outer 1/3 width,condylar height,mandibular ramus height,condylar surface angle,condylar axis angle,condylar volume,condylar surface area and condylar cross-sectional area were measured.RESULTS:There were no significant differences in gender,age,height and disease duration among each group(P＞0.05),while there were significant differences in CBCT characteristic indicators(P＜0.05).Compared with the stationary group,the condylar length,condylar height,mandibular elevation height,condylar volume,condylar surface area and condylar cross-sectional area in the progressive group were significantly reduced(P＜0.05).Taking the stationary or progressive stage of ICR patients as the dependent variable,the variables with significant differences in univariate analysis were included in the random forest(RF)algorithm,the order of importance from high to low was condylar volume,condylar surface area,condylar length,mandibular elevation height,condylar cross-sectional area,and condylar height.The above-mentioned CBCT features were subjected to stepwise RF,when the number of features was 5,the error rate of the out-of-pocket data was the lowest.The order of importance from high to low was condylar volume,condylar surface area,condylar length,mandibular elevation height and condylar area.Using the top 5 variables from the RF importance ranking for analysis,condylar volume,condylar surface area,condylar length and condylar cross-sectional area were identified as influencing factors for ICR staging(P＜0.05).The receiver oper-ating characteristic(ROC)curve analysis demonstrated that condylar volume,condylar surface area,condylar length,condylar cross-sectional area and their combination could all be used to diagnose ICR staging(P＜0.05),with area under the curve(AUC)＞0.70,sensitivity＞58.5％,and specificity ≥64％.Compared with a single indicator,the AUC,sensitivity and specificity of the combined detection were significantly increased.CONCLUSIONS:RF based on the CBCT features of the condyle of ICR patients has a high diagnostic value for disease staging.Condylar volume,condylar surface area,condylar length and condylar cross-sectional area are the key imaging indicators for differentiating the stationary phase from the progressive phase,among which condylar volume is of the highest importance.The combined detection of multi-ple features can significantly improve diagnostic efficiency,manifested as higher AUC,sensitivity and specificity.
PURPOSE:To investigate whether periodontitis(PD)induces microstructural alterations in specific WM tracts,particularly the corticospinal tract(CST),which is associated with motor function.METHODS:Based on genome wide as-sociation study(GWAS)summary statistics from PD(45 563 samples)and CST imaging-derived phenotypes(IDPs)(31 356 samples),two-sample Mendelian randomization(MR)analysis was performed.The primary analysis was conducted using inverse variance weighted(IVW)method,supplemented by weighted median(WM),MR-Egger regression,robust adjusted profile score(MR-RAPS),and constrained maximum likelihood and model averaging bayesian information criterion(cML).Sensitivity analysis was performed using Cochran Q test,Mendelian randomization pleiotropy residual sum and outlier(MR-PRESSO),and leave-one-out(LOO)analysis.RESULTS:MR analysis revealed positive associations between PD and CST fractional anisotropy(FA)(β=0.07,P=6.11×10-3)and negative associations with mean diffusivity(MD)(β=-0.06,P=3.90×10-2).These findings remained consistent across sensitivity analysis.PD led to an increase in FA values and a de-crease in MD within the CST,indicating that the integrity of the CST was compromised.CONCLUSIONS:PD has a detrimental causal impact on the integrity of CST microstructures,potentially increasing the risk of CST lesions.Therefore,this study suggests that effective clinical prevention and treatment of PD are necessary.
PURPOSE:To investigate the cognition,behavior and influencing factors of parents for children malocclusion and early orthodontic treatment,and to provide a reference for clinical education and public health policy development.METHODS:An on-line questionnaire was designed to collect information on the demographic characteristics,oral health care behaviors,perceptions of malocclusion and treatment attitudes of 429 parents of children aged 0-12 years.The col-lected data were subjected to descriptive statistics using SPSS 27.0 software package.Multiple logistic regression analysis was employed to analyze the relevant factors influencing parental perceptions.RESULTS:Among the surveyed parents,91.4％paid attention to children's maxillofacial development,with the main concerns being dental irregularity(39.9％)and bad oral habits(22.8％).Parents had the most sufficient awareness of"mouth breathing"(mean value:2.46)and relatively weak awareness of"tongue-thrusting habit"(mean value:2.18).76.7％of parents supported early medical consultation and intervention for malocclusion,and 48.8％believed that"the earlier the correction,the better".Fifty-six percent of parents self-assessed that they had a sufficient understanding of early orthodontic treatment,and their main information sources were doctor education(72.8％)and online media(54％).Multivariate logistic regression analysis showed that regular oral examinations(OR=3.321)and parents' own history of malocclusion(OR=1.798)could significantly improve their cognitive level(P＜0.001),while educational background and income had no statistically significant impact on their cognition.CON-CLUSIONS:Parents in Hangzhou city have a high overall awareness of malocclusion and early orthodontic treatment,but there are limitations such as excessive attention to aesthetics,neglect of functional problems,and insufficient understand-ing of the intervention.It is recommended to strengthen doctor-led education and use online media resources for profes-sional publicity.
PURPOSE:To explore the application effect of goal attainment theory-based interventions in improving rehabilitation outcomes for patients with jaw fractures,and to provide a basis for optimizing clinical rehabilitation protofiles.METHODS:A total of 30 patients with jaw fractures admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2023 to December 2023 were selected as the control group,and 30 patients admitted from January 2024 to December 2024 as the intervention group.Both groups underwent open reduction and rigid internal fixation with titanium plates.The control group received routine rehabilitation treatment,while the intervention group received rehabilitation treatment guided by the goal attainment theory.Differences in surgical indicators,masticatory ability,tooth bite force,quality of life,and mental health were compared between the two groups.RESULTS:The length of hospital stay and fracture healing time in the intervention group were significantly shorter than those in the control group(P＜0.01),while there were no significant differences in intraoperative blood loss or operation time between the two groups(P＞0.05).At 3 months postoperatively,the masticatory function,tooth bite force,and SF-36 quality of life scores in the intervention group were significantly higher than those in the control group(P＜0.01),but no significant differences were observed in these indicators between the two groups at 6 months postoperatively(P＞0.05).At 6 months postoperatively,the scores of the Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),plaque index(PI),debris index(DI),gingival index(GI),and sulcus bleeding index(SBI)in the intervention group were significantly lower than those in the control group(P＜0.01).The total incidence of complications in the intervention group(3.33％)was significantly lower than that in the control group(10.00％).CONCLUSIONS:Rehabilitation intervention guided by the goal attainment theory can shorten the rehabilitation cycle of patients with jaw fractures,improve masticatory function and quality of life in the early stage,alleviate negative emotions,optimize oral hygiene status and reduce the risk of complications.
