ObjectiveThe aim of this study was to explore the effect and mechanism of programmed cell death ligand 1 (PD-L1) in promoting the proliferation and osteo/odontogenic-differentiation of human dental pulp stem cells (hDPSCs) by mediating CCCTC-binding factor (CTCF) expression.DesignThe interaction between PD-L1 and CTCF was verified through co-immunoprecipitation. hDPSCs transfected with PD-L1 overexpression and CTCF knockdown vectors were treated with lipopolysaccharide or an osteogenic-inducing medium. Inflammatory cytokines and osteo/odontogenic-differentiation related genes were measured. Osteo/odontogenic-differentiation of hDPSCs was assessed using alkaline phosphatase (ALP) and alizarin red S staining.ResultsOverexpression of PD-L1 inhibited LPS-induced pro-inflammatory cytokine upregulation, cell proliferation, ALP activity, and calcium deposition in hDPSCs and elevated the expression of osteo/odontogenic-differentiation related genes; however, such expression patterns could be reversed by CTCF knockdown. Co-immunoprecipitation results confirmed the binding of PD-L1 to CTCF, indicating that PD-L1 overexpression in hDPSCs increases CTCF expression, thus inhibiting the inflammatory response and increasing osteo/odontogenic-differentiation of hDPSCs.ConclusionPD-L1 overexpression in hDPSCs enhances the proliferation and osteo/odontogenic-differentiation of hDPSCs and inhibit the inflammatory response by upregulating CTCF expression.

BACKGROUND:Double teeth are usually the result of an abnormality in the developing tooth germ. Double teeth can occur in either the primary or permanent dentition, with the majority of cases concerning permanent teeth reported in the anterior teeth and less frequently in the molar teeth.CASE PRESENTATION:This report illustrates five cases of double teeth in molars with pulp and periapical disease, including one case of geminated teeth and four cases of fused teeth. Radiographic findings revealed the presence of extra teeth on the buccal aspect of the molar in five cases, with or without communication between the two root canal systems. Root canal treatment was performed by using CBCT and a dental operating microscope. The treatment outcome was good in all five cases.CONCLUSION:The diagnosis and treatment of double teeth requires special attention. The root canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Proper anatomical structure analysis prior to treatment facilitates the development of an appropriate treatment plan, thereby increasing the likelihood of successful treatment both aesthetically and functionally.

Macrophages (MΦ) are highly adaptable and functionally polarized cells that play a crucial role in various physiological and pathological processes. Typically, MΦ differentiate into two distinct subsets: the proinflammatory (M1) and anti-inflammatory (M2) phenotypes. Due to their potent immunomodulatory and anti-inflammatory properties, MΦ have garnered significant attention in recent decades. In the context of bone implant repair, the immunomodulatory function of MΦ is of paramount importance. Depending on their polarization phenotype, MΦ can exert varying effects on osteogenesis, angiogenesis, and the inflammatory response around the implant. This paper provides an overview of the immunomodulatory and inflammatory effects of MΦ polarization in the repair of bone implants.

Titanium mesh and three-dimensional titanium alloy scaffolds play a key role in addressing oral and maxillofacial bone defects, which can provide a specific environment and structure for bone growth and development. The two main causes of implant surgery failure are aseptic loosening and bacterial-induced implant-associated infections. To make bone defect implants effective for a long time, the ideal scaffold should take into account the two functions of osseointegration and anti-infection. Therefore, on the basis of the low-elastic-modulus Ti-10Ta-2Nb-2Zr (TTNZ) alloys developed by the research group in the early stage, this study intends to combine the vancomycin-loaded hydrogel with the 3D-printed through-hole porous titanium alloy scaffold to endow 3D-printed TTNZ scaffolds with antibacterial properties. The antibacterial properties of the complex were investigated by the zone of inhibition test and the adhesion/free antibacterial test. The effects of the composite system on osseointegration were investigated from the aspects of cell adhesion, cell proliferation and osteogenesis-related gene expression. The results showed that loading 2.5 wt.% and 5 wt.% vancomycin did not affect the structure of chitosan-hyaluronic acid hydrogel. The properties of the hydrogels were examined by scanning electron microscopy, Fourier-transform infrared, degradation experiment in vitro and vancomycin release experiment in vitro. When combined with porous scaffolds, the drug-loaded hydrogels exhibited slower drug release rates and longer release times. In addition, in vitro studies found that the TTNZ scaffolds loaded with 5 wt.% vancomycin had a certain effect on the expression of osteogenesis-related genes in cells, but the antibacterial effect was the best. The porous scaffolds loaded with 2.5 wt.% vancomycin hydrogel TTNZ scaffolds did not inhibit cell proliferation, adhesion, alkaline phosphatase activity, and osteogenesis-related gene ex-pression, but the antibacterial effect on free bacteria was not as good as that of TTNZ scaffolds loaded with 5 wt.% vancomycin. This study, complementing the advantages of the two and controlling the local release rate of vancomycin, provides a new idea for future 3D printing of titanium alloy stents for anti-infection.

This study aimed to analyze the effect of emodin on alveolar bone resorption in rats with periodontitis through the interleukin-23 (IL-23)/T helper 17 (Th17) cells inflammatory axis. Twenty-four male Sprague Dawley rats were randomly divided into the following three groups of eight rats each: the control group (group N), periodontitis group (group P), and periodontitis + emodin intervention group (group E). After 2 weeks of continuous emodin intervention, alveolar bone loss (ABL) was evaluated by morphological analysis. Tartrate-resistant acid phosphatase staining was performed to determine the number of osteoclasts (OCs) in periodontal tissue. The ABL and trabecular separation were greater and the number of OCs and the G1/G0 and G2/M phase ratios were higher in group P than those in groups N and E (P < 0.05). In contrast, the trabecular number and thickness were decreased and the S and G2+S phase ratios were lower in group P than those in groups N and E (P < 0.05). However, these indices did not differ significantly between groups E and N. The IL-23, IL-17, RANKL, RANK, RANKL/OPG, IL-2, IL-6, IL-1 beta, and TNF-alpha levels across the three groups were in the order of group P > group E > group N and the OPG levels were in the order of group P < group E < group N (P < 0.05). Emodin may decrease the expression of RANKL and RANK proteins and levels of inflammatory factors; increase OPG, PPAR-gamma, and NF-kappa B protein expression levels; and decrease the number of OCs through the IL-23/Th17 inflammatory axis, thus inhibiting ABL and bone resorption in rats with periodontitis and promoting the proliferation of periodontal ligament cells and alveolar bone repair.

目的 探讨Simodont虚拟仿真系统在口腔住院医师规范化培训中的应用效果.方法 选取于湖南中南大学湘雅口腔医院进行住院医师规范化培训的2020级住院医师20名,采用随机数字表法分为研究组和对照组,每组各10名.研究组和对照组住院医师分别使用Simodont虚拟仿真系统和传统仿头模培训系统进行G.V.Black Ⅱ类洞的制备训练.采用专业化评分和数字化评级比较两组训练效果,并对研究组住院医师进行Simodont虚拟仿真系统使用情况调查.结果 两组住院医师分组训练前的专业化评分及数字化评级比较,差异均无统计学意义(均P＞0.05).研究组住院医师分组训练后的专业化评分和数字化评级均显著提高,且优于对照组,差异均有统计学意义(均P＜0.05).研究组10名住院医师均完全认同使用Simodont虚拟仿真系统进行口腔科操作训练是未来的发展趋势,且认为Simodont虚拟仿真系统比传统仿头模更容易操作;但大部分住院医师也同样认为Simodont虚拟仿真系统对操作者的操作精度要求更高.结论 Simodont虚拟仿真系统的应用有助于提高口腔住院医师的操作水平.建议在充足的Simodont虚拟仿真系统专业培训前提下,将其广泛应用于口腔科临床操作训练.

DM是以高血糖为特征的慢性代谢性疾病,是导致死亡的非传染病之一.DM患者因高血糖加速产生AGEs,AGEs大量蓄积对机体造成损害.牙周病是DM第六大并发症,DM显著增加牙周炎风险.AGEs是DM患者牙周病重要致病因子,对牙周组织造成不良影响.本文就AGEs对DM患者牙周组织相关细胞影响的研究进展进行综述.

The important application of computer imaging technology in the medical field is a necessary auxiliary method for clinical diagnosis and treatment. At present, many people are affected by various factors and have various problems caused by the dental cellular bone. Traditional treatment methods are complex and long, which can cause damage to body tissues. Based on this problem, this paper takes the augmented reality measurement of X-ray dental film as the research object. Based on the in-depth measurement algorithm of the computer image analysis system, two three-dimensional reconstruction methods based on the center of gravity and the matching of the front and side positions are proposed. These two methods only need two X-rays of the front and side of the dental film, the three-dimensional parameters are obtained through calculation and analysis of each spine in the X-ray film, and these parameters are used to fit the dental alveolar bone model. The experimental results prove that the computer-based image analysis system has a great effect on the measurement of X-ray dental film alveolar bone. The positive correlation coefficient reaches 0.87. Compared with the cerebral infarction caused by other methods, the proportion of people with dental film alveolar bone injury is about 15%; after treatment, the functional recovery rate reaches more than 80%. Studies have found that there is a great difference in the age of the population that needs to be treated for dental slices and alveolar bone. The grade of patients is generally under 20 and over 60. This shows that the measurement of X-ray dental film alveolar bone based on computer image analysis system can play an important role in protecting people's oral health.

Objective To compare the ultrasonic, Er, Cr: YSGG laser and Er: YAG laser-assisted 1% sodium hypochlorite (NaOCl) solution on the bactericidal effect of Enterococcus faecalis (E.faecalis) biofilm on the root canal surface and E.faecalis in different depth from dentinal tubules in the apical region. Methods Forty-two single mandibular premolars were used to establish a root canal model of E.faecalis biofilm infection. Two teeth were determined by digital randomization method to establish the model of infection of E.faecalis. The remaining 40 teeth were divided into 5 groups according to the principle of random comparison by digital random method as well as 8 in each group. The groups were: Positive Control: group A: 5.25% NaOCl + 17% EDTA springed, Negative Control: group B: physiologic saline springed, group C: ultrasound + 1% NaOCl, group D: Er: YAG laser + 1% NaOCl, group E: Er, Cr: YSGG + 1% NaOCl. The data from each group were compared using the SPSS 17.0 statistical software for the homogeneity of the experimental data and the normality test to compare the relative sterilization rates between groups and groups. Results (1) Comparison between groups: The sterilization rate of each group was compared. Group B (5.74%)

临床实践教学是口腔医学教育的重要组成部分,牙体牙髓病学也是口腔医学的基础学科,我们结合临床教学实际,对本科实习生、临床规培、进修生等对不同层次的学生实行团队基础学习(TBL)和病例基础学习(CBL)的联合教学法,提高了牙体牙髓病学教学质量.

PURPOSE To study the effect of root canal wall moisture and filling techniques on the sealability of iRoot sp. METHODS Sixty-two undamaged extracted human single-rooted teeth with fully developed apex were selected and prepared by crown-down technique. Two teeth were selected randomly to observe dentin tubules, opening, the residual teeth were randomly assigned to 3 groups: group A (wet), group B (slightly moist),group C(dry).The roots were further divided into 4 subgroups, group a: iRoot sp sealer without a core material (bulk-fill); group b: iRoot sp sealer with single cone obturation techniques; group c: iRoot sp sealer with heated gutta-purcha vertical pressure; group d: iRoot sp sealer with cold gutta-percha lateral compression technique. Glucose microleakage were measured in each group by glucose oxidase method. The differences in distribution of each group were analyzed with SPSS 19.0 software package. RESULTS Group A and group B always showed the maximum and minimum amount of glucose penetration in the whole experimental process, and the difference was statistically significant at 28d (P<0.05). Under the same degree of moisture of root canal wall, glucose leakage of subgroup Aa was significantly higher than that of subgroup Ab and Ac at 15 d; and significantly higher than Ab, Ac, Ad at 21 d and 28 d(P<0.05). In group B and C, the subgroups a, b, c, d had no significant difference from each other during the experimental process(P>0.05). CONCLUSIONS iRoot sp sealer has the best sealing effect when root canals were slightly moist. When the root canal wall is completely dry or slightly moist, the sealability of iRoot sp bulk-fill is similar to that of iRoot sp sealer with gutta-percha filling technique.

目的:探讨不同浓度大蒜素对照品二烯丙基化三硫(dially trisulfide,DATS)体外对粪肠球菌生物膜的作用.方法:体外培养形成粪肠球菌生物膜,分别经1280、2560、5120 mg/L浓度的DATS作用后,采用MTT法观察DATS对生物膜粪肠球菌的抑菌率.结果:1280 mg/L DATS对对数期和饥饿期的生物膜粪肠球菌抑菌率约71％,显著高于对稳定期生物膜粪肠球菌的抑菌率58％,差异具有统计学意义(P＜0.05),随着药物浓度的增高,抑菌率增高.结论:DATS对生物膜中的粪肠球菌具有明显杀灭或抑制作用.

PURPOSE:This study was to evaluate the effect of different master cones on apical microleakage through comparing first penetration depth of spreader and the leakage concentration of glucose in the curved root canal of the extracted posterior teeth filled with different gutta-percha master cones. METHODS:Sixty-six extracted roots of human posterior teeth with a single, curved canal were collected and divided into five experimental groups of 11 roots in each group (Group A:master cone 0.06 tapered, 25#; Group B: 0.06 tapered, 20#; Group C: 0.04 tapered, 30#; Group D: 0.04 tapered, 25#; Group E: 0.02 tapered, 25#) using cold lateral condensation as positive control group(group F, AH-PLUS sealer) of 5 roots and negative control (group G, integrated teeth) of 6 roots. The first penetration depth of spreader and the concentration of glucose in apical reservoir at 1, 2, 4, 7, 10, 15, 20 and 30 days were measured, respectively. The data was analysed with ANOVA and LSD test using SPSS 16.0 software package. RESULTS:The value of working length minus the first penetration depth of spreader in group D was significantly smaller than that in group A and group C(P<0.05),and that in group E was significantly smaller than that in group A ,B,C(P<0.05), but no significant difference(P>0.05) in other groups. The concentration of leakage glucose in group F was significantly higher than that in the other six groups(P<0.05),and there were no significant difference in the five experimental groups (P>0.05),which had no significant difference from the negative control group G(P>0.05). CONCLUSIONS:Choosing smaller tapered master cone could get better apical filling in curved canals, but it has no superiority in apical sealing in short time.

OBJECTIVE:To compare the shaping ability and the influence on apical foramen among hand ProTaper, stainless steel K-files and rotary ProTaper in preparing different curved root canal. METHODS:Forty simulated resin root canal blocks were randomly divided into four groups and prepared by hand ProTaper, stainless steel K-file and rotary ProTaper, respectively. Of them, 12 blocks in group A, B, C consist of six 200 curved root canals and six 30 degrees curved root canals each group. The curvature of the other 4 blocks in group D was less than 5 degrees. Taking photos of the models to the root canal orthotopically and apical foramen using digital camera before and after instrumentation. Finally, the transportation of root canal and the size of apical foramen were analyzed using special image software Auto-CAD. RESULTS:The transportation of center in group B was the highest than that in group A and group C (P<0.05). In some portions of root canal, the transportation of center in group C was higher than that in group A. The size of the apical foramen in group B was significantly bigger than the other groups and the size of the apical foramen in 30 degrees root canal was significantly bigger than that in 20 degrees root canal after instrumentation (P<0.05). There was no significantly different between group A and group C, though the size of apical foramen in group C was bigger than that in group A at the same curvature, and that in 30 degrees root canal was bigger than in 20 degrees root canal (P>0.05). CONCLUSION:Both of the two instruments engender root canal transportation, and curvature is the main reason of transportation. Comparing with stainless steel K-files, NiTi files can maintain the shape of the root canal and apical foramen well.

PURPOSE:To evaluate the effect of smear layer on apical microleakage in extracted root-filled teeth by SEM and glucose penetration model.METHODS:51 straight single-rooted human teeth were randomly divided into 5 groups, instrumented and irrigated differently by groups. 11 teeth in group A were irrigated with 17% EDTA and 1% NaClO,11 teeth in group B with 1% tetracycline hydrochloride and 1% NaClO,11 teeth in group C with 10% citric acid and 1% NaClO, 9 teeth in group D with 1% NaClO only and 9 teeth in group E with 0.9% NaCl. One tooth in each group was observed under scanning electron microscopy. The other teeth were obturated using lateral condensation technique. Leakage along the root filling was measured by the concentration of glucose in apical reservoir at 1, 2, 4, 7, 10, 15, 20 and 30 days respectively with glucose oxidase method. The data were analyzed with repeated measure ANOVA and SNK-q test using SPSS 16.0 software package.RESULTS:No smear layer on the root canal wall was observed in group A, B and C, the leakage was lower than that in group D and E (P<0.05). The smear layer occurred in quantity in group D, E and their leakage increased. The microleakage was higher in group E than that in group D (P<0.05).CONCLUSION:Removal of smear layer on the root canal wall could reduce the root apical microleakage.

Objective:To quantitatively assess the sealing ability of lateral, vertical condensation and Thermafil techniques using glucose penetration model. Method:71 straight human maxillary anterior teeth were divided randomly into seven groups after preparing the root canals using the crown-down technique. Group A(14 teeth)were compacted with vertical compaction and AH Plus. Group B(8 teeth)were compacted with vertical compaction only. Group C(13 teeth) were compacted with lateral compaction and AH Plus. Group D (8 teeth) were compacted with lateral compaction only. Group E(11 teeth) were compacted with Thermafil compaction and AH Plus. Group F(7 teeth) were compacted with Thermafil compaction only. Group G (10 teeth) were assigned to negative control group. Leakage along the root filling was measured by the concentration of glucose in apical reservoir 7,14,21 and 28 days respectively after treatment. Result:Using repeated measure ANOVA,the leakage was significantly different among test groups AC and CE at 7,14,21 and 28 days interval respectively(P< 0.001).But there was no statistically difference between groups A and E(P>0.05).Data from groups C and D varied significantly,however, groups AB and EF showed no difference . The glucose concentration in 21, 28 days were higher than that in 7,14 days in all of the six groups. Conclusion:The sealing ability of lateral compaction technique is better than both of vertical and Thermafil technique. There are the same sealing ability between vertical and Thermafil technique.

<正>临床资料:患者,女,13岁。因"舌痛,舌右缘溃疡4月余"就诊于我院口腔内科。门诊行舌部溃疡病理切片检查,诊断为舌右缘鳞状细胞癌(Ⅰ级),收入院。1月余前患"伤寒",已治愈;并同时确诊系统性红斑狼疮。体检:面色晦暗,双侧面颊部、颈部、左上臂及背部皮肤散在分布暗红色斑丘疹,压之褪色,无压痛,无明显浸润感,表面未见糜烂。