Mesenchymal stem cells (MSCs) are capable of self-replication and multi-directional differentiation, which are very important for the development and reconstruction of mesenchymal tissue. Bone tissue damage repair involves the participation of various cells and molecules. The recovery of bone mass requires sufficiently many MSCs to migrate to the damaged site to perform the reconstruction function. The local inflammatory response at the injury site can recruit MSCs and promote new bone formation. Simultaneously, niche changes during the migration of MSCs will affect their biological performance and initiate the phase of directed differentiation. This article explores the relevant mechanisms that mediate the migration of MSCs in the process of bone injury repair, including the regulation of immune cells and chemotactic signaling molecules in the inflammatory response in the bone repair stage through signaling pathways such as BMP/Smads. Then, it summarizes the mechanism by which the high matrix stiffness upregulates the expression of the integrin and focal adhesions to promote the MSCs migration and osteogenic differentiation. Simultaneously, the migration ability of MSCs can be regulated through drugs or genetic modification to promote the bone injury repair. The improvement of MSCs migration ability can shorten the time of bone tissue damage repair and improve the bone quality. This article reviews the role of the MSCs migration ability in bone tissue injury repair to provide a reference for the application of MSCs with high migration ability in the fields of stem cell therapy for bone related diseases and bone tissue engineering.
Guided bone regeneration technology applied in alveolar bone defect regeneration is based on the barrier function and space maintenance of the barrier membrane. Therefore, traditional development strategies for barrier membranes focus on their physical barrier function, degradation characteristics and biocompatibility to avoid immunogenicity. However, not only does the barrier membrane passively block connective tissue, it is recognized as a “foreign body”that triggers a persistent host immune response, known as a foreign body reaction. The theories of osteoimmunology reveal a close relationship between the immune system and bone system and emphasize the role of immune cells in bone tissue-related pathophysiological processes. Based on these findings, we propose a novel development strategy for barrier membranes based on immune microenvironment regulation: by manipulating mechanical properties, surface properties and physiochemical properties, barrier membranes are endowed with an improved immunomodulation ability, which helps to regulate immune cell reactions to induce a favorable local immune microenvironment, thus coordinating osteogenesis and osteoclastogenesis as well as barrier membrane degradation to increase the efficiency of barrier membranes in GBR applications. In this paper, we review the development of barrier membranes and their close relationship to the immune microenvironment concerning bone regeneration and membrane degradation. Additionally, the outcomes of research on barrier membranes based on the regulation of the immune microenvironment have been summarized to improve the osteogenesis efficiency of barrier membranes and solve the problem of the regeneration and repair of bone defects, especially alveolar bone defects.
Objective To study the changes in levels of interleukin (IL)-6, IL-10, tumor necrosis factor-alpha (TNF-α), and alkaline phosphatase (ALP) in the gingival crevicular fluid (GCF) of patients with severe chronic periodontitis before and after nonsurgical periodontal therapy and to explore the relationship among the levels of these four biomarkers in GCF, their periodontal status and their clinical significance to evaluate the effect of nonsurgical periodontal therapy and periodontitis activity. Methods In total, 30 patients with severe chronic periodontitis were enrolled in a 1-year longitudinal pilot study (Chinese Clinical Trial Registry: ChiCTR-OCH-13004679). At baseline and 1, 3, 6, and 12 months after nonsurgical therapy, the periodontal clinical indicators plaque index (PLI), probing depth (PD), clinical attachment loss (CAL), sulcus bleeding index (SBI) were recorded. Filter paper strips were used to collect two deep-pocket (probing depth ≥ 6 mm) and two shallow-pocket (probing depth ≤ 4 mm) periodontal sites for each patient and weighed. The levels of interleukin IL-6, IL-10, TNF-α, and ALP in GCF were assessed using enzyme-linked immunosorbent assay. Meanwhile, 30 healthy sites of 15 subjects with healthy periodontium were used as the baseline controls for patients with severe chronic periodontitis. Results At the baseline, the TNF-α, ALP and IL-6 levels in GCF of the disease sites of patients with periodontitis were significantly higher than those in healthy periodontal sites of the control group (P < 0.001), and the levels of IL-10 were significantly lower than those in the control group (P < 0.001). In patients with severe chronic periodontitis, the levels of TNF-α, ALP and IL-6 in GCF at deep-pocket sites were significantly higher than those at shallow-pocket sites (P <0.001), and the IL-10 levels were significantly lower than those at shallow-pocket sites (P < 0.001). 1, 3, 6, and 12 months after nonsurgical treatment, the levels of TNF-α and ALP in GCF at the shallow- and deep-pocket sites in patients with chronic periodontitis significantly decreased, the level of IL-10 significantly increased (P < 0.005), and the level of IL-6 in GCF at the deep-pocket sites significantly decreased (P < 0.005). However, there was no significant difference in IL-6 level at shallow-pocket sites (P > 0.05). 1, 3, 6, and 12 months after nonsurgical treatment, the periodontal clinical indicators were improved compared with the baseline. In addition, there was a significant correlation between the levels of these four biomarkers and the periodontal clinical parameters (P < 0.05). During the two follow-up visits after nonsurgical periodontal therapy, the sites with more than 2-mm increase in attachment loss had significant differences in the levels of the four biomarkers in the GCF compared with the previous visit time (P < 0.005). Conclusion The detection of the levels of these four biomarkers in GCF has strong clinical significance for assessing the severity of periodontitis and the efficacy of nonsurgical periodontal therapy. Increased levels of TNF-α, ALP, and IL-6 and decreased IL-10 levels in GCF may indicate periodontitis progression at this site.
Objective To compare the efficacy of different methods in the removal of calcium hydroxide from root canals and to provide a reference for clinical treatment. Methods A total of 160 extracted single-rooted mandibular premolars were instrumented up to ProTaper Universal F4. The roots were split longitudinally, and standardized groove and depression models were prepared and filled with calcium hydroxide. The samples were randomly divided into 4 groups (n=40) according to different irrigation methods: syringe needle irrigation, passive ultrasonic irrigation, XP-endo finisher (XPF) irrigation, and M3-Max irrigation. Each group was then divided into 2 subgroups (n=20) according to the irrigation protocol: NaOCl and NaOCl+EDTA. Photos of grooves and depressions were taken under a microscope after irrigation, and the residual calcium hydroxide was scored to compare the removal effects of different irritation methods and solutions. Results In the groove and depression model, when sodium hypochlorite is used as the irrigation fluid, ultrasound irrigation, XPF and M3-Max are better than syringe needle irrigation in removing calcium hydroxide (P < 0.05); when sodium hypochlorite combined with EDTA flushing, the effect of removing calcium hydroxide with ultrasound irrigation, XPF and M3-Max is better than that of syringe needle irrigation (P < 0.05); but there is no statistically significant difference between ultrasound, XPF and M3-Max (P > 0.05); when compared with the use of sodium hypochlorite, the combined use of EDTA irrigation could enhance the effect of ultrasonic irrigation, XPF and M3 Max on the removal of calcium hydroxide (P < 0.05), but there was no significant improvement in the syringe needle irrigation group (P > 0.05). Conclusion Sodium hypochlorite combined with EDTA can enhance the effect of ultrasonic irrigation, XPF and M3 Max on the removal of calcium hydroxide, and there is no significant difference among these approaches, which are more effective than syringe needle irrigation.
Traumatic temporomandibular joint ankylosis refers to fibrous or bony fusion between the condyle and the glenoid fossa. It can cause problems with mouth-opening limitations, mastication difficulties, obstructive sleep apnea and hypopnea syndrome. When traumatic temporomandibular joint ankylosis occurs during childhood, it can cause facial asymmetry, micrognathia, and malocclusion, which significantly affect the physical and mental health. Once temporomandibular joint ankylosis occurs, it will be refractory and recurrent. The pathogenesis of temporomandibular joint ankylosis has not been completely elucidated and has always been a research hotspot in the oral and maxillofacial fields. In this paper, worldwide research was conducted, and the pathogenesis of traumatic temporomandibular joint ankylosis was clarified, such as “damage of condyle”,“disc displacement or rupture”,“damage to the glenoid fossa” and “lateral pterygoid muscle distraction”. The relative pathogenesis hypotheses were summarized, such as “hematoma organization” and “lateral pterygoid muscle distraction osteogenesis”. The related pathogenesis of traumatic temporomandibular joint ankylosis was discussed based on the latest cytology and molecular biology research.
Objective To investigate the clinicopathological features, treatment and prognosis of oralmucosal malignant melanoma to provide a reference for clinical practice. Methods Data from 19 patients with oralmucosal malignant melanoma were collected, and their clinical manifestations, treatment methods and follow-up results were retrospectively analyzed. Results Among the 19 patients, 11 cases (58%) had lesions in the gingiva, 7 cases (37%) had lesions in the palate, and 1 case (5%) had lesions in the tongue, the difference was statistically significant (P<0.05). Eight patients had regional lymph node metastasis with a metastasis rate of 42%, of which 4 cases had multiple site metastasis, and the total number of regional lymph node metastasis sites was 15. Among the 19 patients, 3 cases received only surgery, 4 cases received cryotherapy, and 12 cases received combined surgery, cryotherapy and biological immunotherapy. Pathological examination showed malignant melanoma. The positive rates of S-100, HMB-45 and Melan-A were 95%, 89% and 84%, respectively. Kaplan-Meier survival analysis showed that patients with lesions less than 5 cm2 had a higher survival rate (P < 0.05). Conclusions Oral malignant melanomas usually present as black lesions in the oral mucosa, which are prone to metastasis in early stage. The area of lesions may affect the prognosis of the disease. Therefore, the large range of black lesions or masses should be the alert for the clinicians. Oral malignant melanoma patients are usually treated with combined treatment with surgery, cryotherapy and biological immunotherapy.
Objective To construct a hit-deficient mutant strain of S. mutans ATCC25175 and verify its cell cycle regulatory function. Method Genomic DNA was extracted from S. mutans ATCC25175 strains, and then the upstream and downstream DNA fragments of the hit gene were cloned into the pFW5 vector (spectinomycin resistant) to construct recombinant plasmids using PCR amplification. Third, employed by natural genetic transformation in S. mutans ATCC25175 strains, the linearized recombinant plasmids were transformed into their genetic competence, induced by the synthesized competence-stimulating peptide (CSP), and then, homologous recombination was utilized to produce crossover and noncrossover products. Fourth, the hit-deficient mutant strains of S. mutans ATCC25175 were screened through the spectinomycin-resistance marker and identified by the electrophoresis of PCR products and PCR Sanger sequencing. Finally, its growth rate in vegetative BHI medium was also investigated. Results The upstream (856 bp) and downstream (519 bp) DNA fragments of the hit gene from the genomic DNA materials of S. mutans ATCC25175 were cloned into two multiple cloning sites (MCS-I and MCS-II) of the pFW5 vector, respectively, and the recombinant plasmid pFW5_hit_Up_Down was constructed and identified by double-emzyme digestion and PCR Sanger sequencing. The linearized recombinant plasmids were transformed into their genetic competence, induced by the synthetic CSP, and then, homologous recombination was utilized to produce various products. The hit-deficient mutant strains of S. mutans ATCC25175 were screened through the spectinomycin resistance marker and identified by the electrophoresis of PCR products and Sanger sequencing. The growth rate of the hit-deficient mutant strains versus their parental S. mutans ATCC25175 strains was increased greatly (P<0.001). Conclusion The hit-deficient mutant strains of S. mutans ATCC25175, having heritable traits, were successfully constructed, and the encoding Hit protein is growth-phase regulated in the cell cycle.
Mandibular defects in adolescents are mostly caused by surgical resection of benign and malignant tumors, trauma and jaw inflammation. The reconstruction of mandibular defects in adolescents is challenging. In addition to solving the problem of jaw reconstruction in adults, some clinical factors, including the influence of surgery on the growth of donor and recipient areas, the long-term effects of reconstruction, and the outcome of bone grafts, must also be considered. At present, the main reconstructive methods include autogenous bone grafts and distraction osteogenesis. Autogenous bone grafts are still the gold standard due to their long-term effects. Favorable growth potential after repair was shown in adolescent cases of mandibular reconstruction with fibula flap. Normal occlusion was restored, and a long-term stable effect was achieved in cases of condylar reconstruction with costal cartilage. The safety and clinical effects of distraction osteogenesis have been confirmed, but the long-term effects of large-scale mandibular defects are still uncertain. In addition, other tissue engineering techniques also have good application prospects for the repair and reconstruction of adolescent mandible defects, but more in-depth basic research and more extensive clinical trials should be performed to verify the efficacy.
Chronic kidney disease is a global public health problem threatening human health and affects the function of multiple organ systems. The oral health of patients is often affected as the disease progresses. Dental implants have become the best way to repair tooth loss. It is necessary and challenging to provide safe and reliable dental implant treatment for patients with chronic kidney disease. Dental clinicians should evaluate the health of patients comprehensively, complete blood biochemistry, coagulation function, and imaging examinations, and provide feasible, reliable and personalized treatment plans. During the treatment phase, dental clinicians need to consider prophylactic antibiotics, painless minimally invasive surgery, infection control, and delayed restoration, and they must cooperate with other clinicians in multiple disciplines to reduce risks to provide personalized, safe, and effective oral implant treatment for patients with chronic kidney disease.
The Streptococcus mutans (S. mutans) phage, as one of the principal pathogenic bacteria of dental caries, is a main cause of the formation and development of dental caries due to its overproliferation in dental plaque biofilms. Bacterial viruses, also known as bacteriophages, have the capability of specifically infecting bacteria and effectively degrading bacterial biofilms. S. mutans phages, therefore, may prevent and control caries. Therapy based on phages has been applied in many fields, but the application of S. mutans phages in caries remains exploratory. This article will review the research progress of S. mutans phages in clinical caries prevention, aiming to provide a new idea for the clinical prevention of caries. The results of the literature review show that the living bacteriophage system has the advantages of high specificity, high affinity and good safety. However, due to its unstable structure, it can be processed into a more stable formulation by freeze-drying, spray drying, adding stability enhancers, or incorporating bacteriophages into ointments, biodegradable polymer matrices or particles to a certain extent to improve stability. The lysozyme produced by phages can digest the bacterial cell wall and release the assembled phage particles, which effectively cleave biofilms. In addition, the antigen binding fragment library for cariogenic pathogens was screened by phage display technology, and the purpose of caries prevention and treatment was achieved by passive immunization of antigen binding fragments. However, the host range of bacteriophages is narrow, so this kind of problem can be overcome by phage combined with traditional therapy or other drug use or cocktail therapy with multiple phages in clinical caries prevention and control.
Objective Systematic evaluation of the correlation of HLA-DQB1 and HLA-DRB1 allele polymorphisms with caries, to provide reference for caries prevention and treatment. Methods Relevant literature published before December 2020 was searched in the Cochrane Library, PubMed, Embase, Web of Science, Scopus, CNKI, Wanfang, VIP, and CBM databases. Meta-analysis was performed using the R4.0.2 software to test for heterogeneity and evaluate the publication bias. Results In total,10 case-control studies were included with 564 people in the case group and 676 people in the control group. The results of the Meta-analysis show that: ① HLA-DQB1*02 (OR=0.52, 95%CI=0.29-0.93, P < 0.05) and HLA-DRB1*09 (OR=0.34, 95%CI=0.21-0.58, P < 0.05) are protective factors of dental caries; ② HLA-DRB1*13 (OR=2.96, 95%CI=2.03-4.33, P < 0.05) and HLA-DRB1*14 (OR=1.95, 95%CI=1.26-3.02, P < 0.05) alleles are risk factors for the development of dental caries. The results of the subgroup analysis are: HLA-DRB1*07 is a caries susceptibility factor in the Chinese population (OR=0.48, 95% CI=0.24-0.97, P < 0.05), while it is not statistically significant in the Brazilian and Turkish populations; HLA-DRB1*11 is a caries protective factor in the saliva group (OR=2.26, 95% CI=1.46-3.52, P < 0.05). 3.52, P < 0.001), while it is a caries susceptibility factor in the blood group (OR=0.09, 95% CI=0.12-0.34, P < 0.001). Conclusion HLA-DRB1*13 and HLA-DRB1*14 alleles are caries susceptibility genes, and HLA-DQB1*02 and HLA-DRB1*09 have protective effects on the caries development. HLA-DRB1*07 is a caries susceptibility gene in the Chinese population; HLA-DRB1*11 is a caries protective gene in the saliva group. Due to the limited sample size and quality of the included studies, more high-quality studies will be included later for verification.
Objective To observe the root and root canal morphology of mandibular second molars in Western Guangxi by CBCT, to provide a reference for clinical diagnosis and treatment. Methods In total, 564 patients′ 1 128 mandibular second molars that satisfy the inclusion criteria were analyzed with a planmecaromexis CBCT machine and its own image analysis software. The patients′ gender, age and ethnic differences in the root and canal morphology and the symmetry of the bilateral root and canal were statistically analyzed. Results Among the 1 128 mandibular second molars, 662 were the Zhuang ethnic group and 384 were the Han ethnic group, and 82 were other ethnic groups; the double root type and C-shaped root type accounted for a relatively high proportion: 73.94% and 24.47%, respectively. The detection rates of the double root type were higher in males than in females (P < 0.05); the detection rates of the C-shaped root type were higher in females than in males (P <0.05); the root type of the teeth was mainly double-rooted in the Zhuang ethnic group (P<0.01). The incidence of type IV in the mesial root of the double root type mandibular second molar was the highest (P < 0.01), and the incidence of type I in the distal root was the highest (P < 0.01). The C-shaped root canal is more continuous at the mouth of the root canal, more downward corresponds to a worse continuity: in three different levels of root canal orifice, root middle and root apex, the root canal orifice is dominated by the C1 type, and both root middle and root apex are mainly C3-type (P < 0.01). The difference in symmetry of bilateral roots and root canals was statistically significant among different gender groups, age groups, and ethnic groups (P < 0.05): there were more males than females, the results in the 18-35-year-old group and the Zhuang ethnic group were higher. Conclusion The root and root canal morphology of mandibular second molars in western Guangxi people are complex and changeable. The roots are mainly double root type in the Han ethnic group and the Zhuang ethnic group. C-shaped roots are also common. The detection rate of C-shaped roots in the Zhuang ethnic group was higher, and the symmetry rate of bilateral roots and that of bilateral root canals was higher in the Zhuang ethnic group than in the Han ethnic group.
Objective To prepare a copper-nobium antibacterial coating on a titanium surface by a microarc oxidation-microwave hydrothermal two-step method and to study its surface structure and antibacterial properties. Methods Using titanium coated with a microarc oxidation coating (MAO group) as the substrate, copper and niobium were introduced by a microwave hydrothermal method in low (MHL-Cu group), medium (MHM-Cu group) and high (MHH-Cu group) copper chloride solutions and niobium oxalate (MH-Nb group) solutions, respectively. The component with the highest copper content was determined by energy spectrum analysis, and the copper-niobium composite coating (MH-Cu/Nb group) was prepared by microwave hydrothermal mixing with niobium oxalate. The microstructure, element distribution and phase composition of the specimens were characterized by scanning electron microscopy, energy dispersive spectrometry and X-ray diffraction, and the bacteriostatic effect of the coating onEscherichia coliand Staphylococcus aureus was determined by the film method. Results Energy dispersive spectrometry showed that Cu was introduced onto the surface of the MHL-Cu, MHM-Cu, and MHH-Cu groups, and the atomic ratios of copper in each group were （0.68 ± 0.04）%,（1.17 ± 0.06）%, and （1.64 ± 0.03）%. The difference between groups was statistically significant (P< 0.01). Scanning electron microscopy showed a crater-like porous structure on the surface of the MAO group, and the MHL-Cu, MHM-Cu, MHH-Cu, MH-Nb, MH-Cu/Nb groups maintained micropore morphology. The roughness increased with increasing Cu2+ concentration, in which the MH-Nb and MH-Cu/Nb groups showed gully like structures simultaneously. X-ray diffraction showed that the coating of the MAO group was mainly composed of titanium and anatase phase TiO2, and the coatings of the MHL-Cu, MHM-Cu, MHH-Cu, MH-Nb, MH-Cu/Nb groups were mainly composed of anatase and rutile phase TiO2. Compared with the MAO group, Escherichia coli and Staphylococcus aureus in the MHH-Cu, MH-Nb, MH-Cu/Nb groups decreased to varying degrees, with significant differences (P< 0.001); compared with the MH-Cu/Nb group, the colony number difference had statistical significance (P> 0.05).Conclusion The rough, porous coating containing copper and niobium prepared by the microarc oxidation-microwave hydrothermal two-step method can effectively inhibit the growth ofEscherichia coli and Staphylococcus aureus.
The nature, significance, parameters, influencing factors and testing of implant primary stability were studied by a literature review. Primary stability is a kind of anchorage force at the interface between the implant and bone, and it is merely mechanical. The significance of primary stability is to keep the implant unmovable so that the new bone can grow undisturbed on the surface of the implant without interference from fibrous tissue. The implant is finally bound to the bone by osseointegration. The most common assessments of primary stability are insertion torque (IT), the implant stability quotient (ISQ) of the resonance frequency analysis (RFA) and Periotest. IT is more commonly used to directly imply initial stability. At present, no consensus has been reached regarding the concrete parameters of primary stability to predict osseointegration. Implant osseointegration could be developed through all phases of primary stability. However, the excessive primary stability would cause mini-bone fractures, followed by bone necrosis at the interface and the final failure of implantation. Primary stability is influenced by three factors: implant design, bone condition of alveolar bone, and surgical technique. Under the condition of a lack of primary stability and immediate implantation, there may be the possibility of successful osseointegration. Therefore, it is necessary to re-examine the accuracy of the current elaboration on the primary stability. It is related directly to whether the clinic can choose the appropriate implant treatment path.
Objective To explore the potential mechanism of the main active component Tripterygium wilfordii in the treatment of oral lichen planus based on network pharmacology. Methods The components of Tripterygium wilfordii and targets were searched through the Traditional Chinese Medicine system pharmacology database and analysis platform (TCMSP) and the Traditional Chinese Medicine integrated database (TCMID) databases. The related targets of oral lichen planus (OLP) were obtained through databases such as Gene Cards. The OLP targets were mapped by Venn analysis to the targets of Tripterygium wilfordii to screen out the common targets as the treatment of OLP targets of Tripterygium wilfordii. The Cytoscape software and STRING were used to construct a chemical component-target network and protein-protein interaction network, a network analyzer was used to compute the network topology properties, a cluster profiler software was used to analyze the GO classification enrichment analysis and KEGG signal path analysis, and a Tripterygium wilfordii chemical components-targets-pathway network diagram was constructed. Results Twenty-three components and 44 OLP treatmenttargets of Tripterygium wilfordii were obtained. The key active ingredients of Tripterygium wilfordii in the treatment of OLP are triptolide, kaempferol, and tangerine peel. The key targets include TNF and AKT1. The GO classification enrichment analysis obtained 63 GO terms, which are mainly involved in the leukocyte differentiation and reaction to lipopolysaccharides. The KEGG analysis identified 111 signaling pathways, which are mainly related to the TNF signaling pathway and IL17 signaling pathway. Conclusion Based on the network pharmacology, this study preliminarily revealed themain components, targets and pathways of Tripterygium wilfordii in the treatment of OLP. This study can provide a theoretical basis for further research to explore drugs with high activity and low toxicity to treat OLP from Tripterygium wilfordii.
The evaluation of immune function plays an important role in the diagnosis, treatment and prognosis of many diseases. To date, immune function detection includes cellular immunity, humoral immunity, and inflammatory markers. In this paper, the application of immune function detection in the diagnosis, differential diagnosis and treatment monitoring of various diseases was discussed; then, the application value of immune function detection in the diagnosis and treatment of three common oral mucosa-related diseases, including recurrent aphthous ulcer (RAU), oral lichen planus (OLP), and oral squamous cell carcinoma (OSCC), were reviewed combined with the literature and our research. Our research found that RAU patients present abnormal humoral immune function and obvious inflammatory reactions, whereas OLP and OSCC patients present mild inflammatory reactions and more serious abnormal cellular and humoral immune function, so the combined detection of immune function has a certain guiding value for the diagnosis and treatment of these diseases. Moreover, in the future, it is necessary to carry out a study on large sample, multicenter and multiindex joint detection to better clarify the role of immune dysfunction in the pathogenesis of various diseases and its mechanism, to establish the corresponding diagnostic model and prognostic prediction model, to find more effective treatment methods.
Objective To detect the composition of the subgingival microbiota in generalized aggressive periodontitis (GAgP) and severe chronic periodontitis (SCP) patients tested by high-throughput sequencing (HTS) technologies, analyze its diversity and function by using bioinformatics, and observe changes in the subgingival microbiota before and after periodontal initial therapy. Methods Eleven patients with GAgP and 14 patients with SCP who visited the Department of Periodontics in Stomatological Hospital of Kunming Medical University from September 2018 to May 2019 were recruited, and subgingival plaque samples were collected at baseline and 6 weeks after initial therapy. Then, the genomic DNA was distracted and sequenced by the Illumina MiSeq high-throughput sequencing platform. QIIME (quantitative insights in microbial ecology), Mothur, SPSS and other software were used to analyze community information. LEfSe difference analysis (linear discriminant analysis effect size), network analysis, and the KEGG PATHWAY database (
) were used to predict community function. Results At baseline, the dominant microbiota of GAgP and SCP patients were similar, including Bacteroidetes, Porphyromonas and Porphyromonas endodontalis. Six weeks after initial therapy, as the periodontal pocket became shallower, the variation trend of the microbiota of GAgP and SCP patients was similar. The relative abundance of gram-negative bacteria, such as Bacteroidetes, Porphyromonas and Porphyromonas endodontalis, decreased, while the relative abundance of gram-positive bacteria, such as Proteobacteria, Actinomyces and Rothia aeria, increased. Actinobacteria were significantly increased biomarkers of the subgingival microbiota in GAgP after treatment. Streptococcus is an important genus that connects the microbiota related to periodontitis and the microbiota related to periodontal health. Community function prediction result showed that initial treatment can reduce the functions of amino acid metabolism, methane metabolism, and peptidase in GAgP and SCP patients. Conclusion The subgingival microbiota of GAgP and SCP patients are similar. Streptococcus, as an early colonizer, may play an important role in promoting plaque biofilm formation and maturation in the process of subgingival flora from health to imbalance. Initial therapy can change the composition and structure of the subgingival microbiota, reduce community diversity, and reduce the functions of amino acid metabolism, methane metabolism, and peptidase in GAgP and SCP patients.
Objective To investigate the clinical effect of periodontal endoscope-assisted scaling and root planing (SRP) in treating advanced periodontitis. Methods Nineteen cases of grade Ⅲ and Ⅳ periodontitis selected from June 2017 to January 2019 in the Nanjing Stomatological Hospital, Medical School of Nanjing University were divided into the periodontal endoscope and control groups. In the periodontal endoscope group, SRP was performed under a periodontal microscope in one treatment after initial supragingival scaling; in the control group, SRP was performed under regular conditions, and additional SRP was conducted in positive bleeding on probing sites twice every other week as needed. Periodontal status, including probing depth (PD), bleeding on probing (BOP) and attachment loss (AL), was recorded by a Florida probe. Results For sites of 4
P < 0.05). There was no significant difference between the two groups at 6 months (
P >0.05). There was no significant difference in the BOP positive rate or AL change between the two groups at 3 months and 6 months (
P > 0.05). For sites with PD > 6 mm, at baseline, the positive rates of PD, BOP and AL in the endoscope group were more serious than those in the control group, and the differences were statistically significant. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. However, PD in the endoscope group became shallower than that in the control group (
P < 0.05) after 3 and 6 months. There was no significant difference in the BOP positive rate or AL between the two groups (
Conclusion When compared to regular SRP, periodontal microscope-assisted SRP achieves better improvement in PD and is more beneficial for reducing the BOP and AL of deeper sites.
Objective To investigate the differences and clinical significance of circRNA expression profiles in oral leukoplakia (OLK) tissues and normal oral mucosal (NOM) tissues. Methods High-throughput sequencing was used to detect differentially expressed circRNAs in 6 pairs of OLK and NOM tissues, and qRT-PCR was used to verify the expression of 10 circRNAs screened in 6 pairs of OLK and NOM tissues. The ring formation of circRNA was verified by RNase R digestion and Sanger sequencing, and the target circHLA-C was further verified by qRT-PCR in 20 pairs of OLK and NOM tissues. CircHLA-C was visualized using the UCSC genome browser (genome.ucsc.edu). The function of differentially expressed circRNAs was analyzed by GO and KEGG enrichment analyses. TargetScan and miRanda predicted the downstream miRNAs and mRNAs of the target circRNAs, and a ceRNA network related to the identified circRNAs was constructed in Cytoscape. Results Sequencing analysis showed that 366 circRNAs were significantly differentially expressed in OLK tissues, including 65 upregulated and 301 downregulated circRNAs. After qRT-PCR verification, 7 of the 10 screened circRNAs were expressed consistent with the sequencing results. The upregulated circHLA-C was confirmed to be a real circRNA with back-splice junction sites by RNase R digestion and Sanger sequencing. Correlation analysis showed a positive correlation between circHLA-C and the degree of OLK dysplasia. ROC curve analysis suggested that circHLA-C had potential value in diagnosing OLK with high accuracy and specificity. Conclusion CircRNA was significantly abnormally expressed in OLK tissues, and the upregulation of circHLA-C may be related to the degree of OLK dysplasia, providing guiding value for the diagnosis of OLK in the future.
Objective To study the effects of different concentrated sulfuric acid etching durations on the shear bond strength between polyether-ketone-ketone (PEKK) and dentin, providing a scientific basis for the clinical bonding procedures of PEKK prosthesis. Methods Forty-four PEKK specimens were prepared and randomly divided into four groups: group A was the control group, which was only polished with abrasive papers, group B, group C and group D were experimental groups, which were etched by 98% concentrated sulfuric acid for 5 s, 30 s and 60 s, respectively. In addition, one sample was randomly selected from each group, and the profile was prepared by a slow cutting machine. The surface morphology of the profile was observed under SEM. After the four groups of specimens and dentin were bonded by resin, they were soaked in distilled water at 37 ℃ for 24 h. After the shear bonding strengths were measured, the fracture interfaces of the specimens were examined by the scanning electron microscopy and stereomicroscopy, and failure models of bonding were analyzed. Results After acid etching treatments, the cross-sectional images in group B presented uniform spongy shapes, while the cross-sectional images in group C and group D showed destructive pore structures. The shear bond strengths of group B (16.84 ± 1.84) MPa, group C (12.33 ± 1.22) MPa and group D (6.44 ± 1.18) MPa were higher than that of group A (3.99 ± 1.06) MPa (P < 0.05). The highest shear bond strength was observed in group B (16.84 ± 1.84) MPa. Conclusion The surface treatment of 98% sulfuric acid etching for 5 s manifested the best bond strength between PEKK and dentin.
Transverse maxillary deficiency is a common malocclusion in the clinic. Palatal expansion techniques are commonly used in the treatment of maxillary transverse deficiency. Traditional palatal expansion techniques have good effects on the treatment of children and adolescents whose palatal suture has not yet closed, but the effects on adult patients are unsatisfied. New palatal expansion techniques, such as miniscrew-assisted rapid palatal expansion and surgical-assisted maxillary expansion, have increased the age-related indications for palatal expansion, and their bone expansion effect has been strengthened. With the development of CAD/CAM technology and 3D printing technology, techniques such as Invisalign and personalized appliances have been developed and have promising application prospects. To provide references for the clinical treatment of maxillary transverse deficiency, palatal expansion techniques are reviewed from the following aspects: mechanism and indications, expansion pattern, traditional and new palatal expansion appliances, stability and retention of palatal expansion, outlook of future expanders, etc.
Orthodontic treatment for dentofacial deformity is fundamental throughout the entire management process of cleft lip and palate. Orthodontist is one of those who are indispensable in the comprehensive multidisciplinary cleft team. Cleft lip and palate patients have unique dentofacial characteristics which makes the treatment goals and strategies different from those of other patients in different stages. For newborns with cleft lip and palate, the main treatment includes presurgical orthopedics. For patients in their primary dentition stage, the treatment mainly focuses on the prevention of bad oral habits and severe malocclusion. For those in their mixed dentition stage, the treatment mainly consists of dentition preparation for alveolar bone grafting and skeletal growth modification. For patients in their permanent dentition stage, treatment strategies include orthodontic camaflouge treatment, combined orthodontic-orthognathic approach and segmental alveolar distraction osteogenesis. In addition to routine orthodontic treatment, orthodontists should pay special attention to managing the compliance of cleft lip and palate patients with unique psychological characteristics. By summarizing the state-of-art cleft lip and palate orthodontic care in the multidisciplinary team, this review aims to involve more orthodontic clinicians to join in the modern biopsychosocial medical practice of cleft lip and palate team approach and to improve the standard of care for cleft lip and palate patients.
Objective To compare the stress distribution of different all-ceramic restoration materials and thicknesses in dental crown restorations using the finite element method and provide a reference for the selection and design of clinical crown restoration materials. Methods A finite element model of mandibular first molar implant crown restoration was created, and 6 crown thickness designs and 4 different crown restoration materials were evaluated, namely, resin-based ceramics (Lava Ultimate and Vita Enamic), lithium disilicate glass-ceramics (IPS e.max CAD), and zirconia ceramic (Cercon) designs. The mandibular first molars were loaded at 600 N, and the stress distribution was analyzed by using the finite element software ANSYS 10.0. Results The crown stress analysis showed that 156.05 MPa was the highest in 4 mm Cercon group and 18.85 MPa was the lowest in 1 mm Lava Ultimate group. The stress analysis of resin cement showed that 62.52 MPa was the highest in the 4 mm Lava Ultimate group and 16.74 MPa was the lowest in 1 mm IPS e.max CAD group. During the use of the finished platform, the stress concentration of the Lava Ultimate group in the crown prosthesis and resin cement was higher than that of the personalized platform with the same crown thickness. Conclusion With increasing crown thickness, the maximum principal stress concentration in crown restoration and resin cement increases. Personalized abutments are more conducive to reducing stress concentrations for resin-based ceramics.
Objective The purpose of this study was to investigate the effect of different concentrations of exosomes (Exos) secreted from dental folic cells (DFCs) preconditioned with lipopolysaccharide (LPS) on the osteogenic differentiation ability of periodontal cells in periodontitis (p-PDLCs) in patients to provide a basis for the prevention and treatment of periodontal disease. Method Tissue block and enzyme digestion methods were used to culture DFCs and p-PDLCs. Exosomes were isolated from 250 ng/mL LPS-preconditioned DFCs 24 h later. The characteristics of exosomes were detected by transmission electron microscopy, particle size analysis and Western blotting. The effects of 10 μg/mL and 100 μg/mL exosomes on the osteogenic differentiation of p-PDLCs were detected by RT-PCR and Alizarin red staining. Results LPS-pretreated DFC-derived exosomes (L-Exos) are vesicle-like structures with a size between 30-100 nm that positively express CD63 and Alix. Compared with the control group, exosomes significantly upregulated Periostin, Col Ⅰ, and Col Ⅲ expression at 100 μg/mL (P < 0.05), while TGF- β1 was significantly upregulated at 10 μg/mL (P < 0.01). At 7 days after osteogenic induction, mineralized nodules were significantly more abundant in the exosome group than in the control group (P < 0.01), and the results were better at a concentration of 100 μg/mL (P < 0.01). Conclusion 100 μg/mL L-Exos are better than 10 μg/mL L-Exos in enhancing the osteogenic differentiation ability of p-PDLCs.
Minimally invasive endodontics (MIE) can preserve dental tissue to a greater extent and improve the success rate of endodontics and has thus attracted increasing attention. 3D printing is a technology that is based on a digital model and uses powdered metal, plastic and other materials to construct objects by printing layer by layer. This article reviews the application of 3D printing technology in minimally invasive endodontics to provide a reference for the application of 3D printing technology in clinical minimally invasive endodontics in the future. In recent years, 3D printing technology has been widely used in various professional fields of stomatology, such as maxillofacial surgery, prosthodontics, and orthodontics. Using cone beam computed tomography (CBCT) and oral scanners to obtain accurate data on the internal and external structures of teeth combined with 3D printing to construct a tooth diagnostic model and pulp opening guide plate, we can accurately locate the position of the root canal and provide a new method for minimally invasive endodontics. At present, 3D printing technology is mainly used to guide the pulp opening pathway, assist in the minimally invasive treatment of malformed teeth and calcified root canals, and assist with apical surgery in the field of minimally invasive endodontics. However, its accuracy and clinical prognosis still need to be verified with a large number of clinical cases.
Objective To explore the clinical effect of bulk-fill composite resin combined with transparent preformed crowns for aesthetic restoration of deciduous incisor of children. Methods A predesigned clinical prospective randomized controlled research method was used to select 90 patients (123 teeth). The random number table method was divided into three groups: A, B, and C. Group A was treated with a bulk-fill composite resin of SF (SonicFill) combined with a transparent preformed crown (41 teeth in 30 cases), and group B was treated with a large block of Tetric N-Ceram Bulk Fill Composite resin combined with transparent preformed crowns (39 teeth in 29 cases). Group C was treated with 3M Z350 XT universal nano resin combined with transparent preformed crowns (43 teeth in 31 cases). The visual analog scale (VAS) and the modified USPHS standard were used to evaluate the completeness, marginal steps, marginal discoloration, surface condition, secondary caries and satisfaction of the parents with prostheses after 12 months. Results Twelve months after the operation, the evaluation indexes of group A were better than those of group B and group C, and the differences were statistically significant, including edge integrity (χ 2=10.847, P=0.028), edge step (χ 2=7.799, P=0.020), edge discoloration (χ 2=10.391, P=0.034), surface state (χ 2=11.476, P=0.021), and secondary caries (χ 2=10.447, P=0.034). The satisfaction of parents in group A on the overall contour (χ 2=10.238, P=0.037), shape and texture (χ 2=11.521, P=0.021) were better than those in group B and group C, and the differences were statistically significant. There was no significant difference in the evaluation of color satisfaction among the three groups (χ 2=0.990, P=0.610). Conclusion SonicFill bulk-fill composite resin combined with transparent preformed crown is good for short-term aesthetic restoration of deciduous incisor, and parental satisfaction is high.
With the rapid development of implant technology, implant restoration is a conventional treatment option for adult patients with tooth loss. Severe dental lesions, trauma, tumors, abnormal development and other reasons can cause dental defects and even dentition loss in children and adolescents. There has been hesitation to perform implant therapy for growing children because of the growth period; thus, little is known about the outcomes of the osseointegration procedure in young patients. Therefore, this article reviews the current literature to discuss the use of dental implants in children and adolescents. According to current studies, orthodontic treatment or transitional restoration should be undertaken based on the characteristics of the children and adolescents. Implant surgery should be performed after the end of the peak growth period. For patients with severe dentition defects, relevant criteria should be established before implant surgery to evaluate the effect of implant therapy in children and adolescents. The patients should be treated with a multidisciplinary, staged and long-term treatment approach. Most of the recent literature consists of case reports and short-term studies. There is an urgent need for more studies in this field with long-term follow-up.
Orthodontic tooth movement is a complex physiological process based on periodontal tissue remodeling. Numerous factors, such as the anatomical characteristics of oral and maxillofacial complications, occlusal interference, mechanical factors and systematic factors, may play critical roles in orthodontic tooth movement, leading to tooth movement difficulty. In recent years, many scholars have focused on factors related to tooth movement difficulty, but current research mostly involves animal experiments and retrospective studies. Clinical trials of high-quality and evidence-based medicine studies are required. Although no sound theory system is available that is universally recognized and the mechanism of many factors remains debatable, alveolar bone defects, the maxillary sinus, the gingiva, tooth ankylosis, bone islands and friction may cause orthodontic tooth movement. Understanding the factors related to the difficulty of orthodontic tooth movement is advantageous to develop a more comprehensive personalized treatment plan for patients and achieve more efficient and safer tooth movement. In this paper, the current factors related to orthodontic tooth movement are reviewed to provide references for clinical orthodontic treatment.
Treponema denticola is an important pathogenic Treponema pathogen in the human oral cavity. Early studies have found that Treponema denticola is closely related to the occurrence and development of periodontal diseases. With the development of technical methods in recent years, many studies have shown that Treponema denticola not only can participate in periodontal diseases through a variety of mechanisms but also can play an important role in the development of various oral diseases. Treponema denticola is detected in high concentrations in peri-apical diseases and peri-implant diseases, and its surface protein is also prevalent in oral tumor samples. This paper reviews the research progress of Treponema denticola in periodontal diseases, pulp peri-apical diseases, peri-implant diseases and oral tumors, and summarizes the relevant mechanisms. For example, Treponema denticola can cause immune regulation disorder, destroy the epithelial barrier, induce bone absorption, promote the occurrence and development of inflammation through a variety of surface proteins, including chymotrypsin-like protease complex (CTLP), major outer sheath protein (Mosp), Td92, and LOS. It can also escape complement-mediated killing effects through surface FhbB lipoproteins and promote the occurrence and development of oral tumors by regulating the tumor microenvironment. These theories provide a theoretical basis for further understanding the development of oral diseases, controlling the infection of Treponema denticola, and exploring more effective treatment strategies.
Bonding of brackets to dental fluorosis has always been a difficult problem for clinicians. At present, clinical research has adopted several methods to facilitate bracket bonding, including prolonging etching time, enamel microabrasion, enamel ground, using adhesion promoter and laser etching. Prolonging etching time is suitable for mild-to-moderate dental fluorosis with easy chair-side operation; however, over-etching may cause severe tooth damage. Microabrasion can be applied to mild dental fluorosis while removing pigment deposition simultaneously; however, rubber dam protection is needed. Enamel ground can improve the bond strength to all kinds of dental fluorosis at the price of removing a relatively large amount of superficial enamel. Adhesion promoters might improve the bond strength of moderate to severe dental fluorosis; however, the current results conflict with one another. This needs further verification using larger-sample clinical trials. Laser etching has no effect on improving bond strength; however, it can remove pigment without destroying tooth enamel, which is worth further modification and enhancement.
Periodontitis is the inflammation of periodontal tissue caused by dental plaque, which absorbs the alveolar bone and cementum. The immune response triggered by CD4+T cells is the key factor for the aggravation of periodontitis. The activation of dendritic cells and the receptor activator of the NF-κB ligand (RANKL) pathway is an important link in the alveolar bone resorption of periodontal tissue. Pro-inflammatory factors such as interferon-γ (IFN-γ), tumor necrosis factor (TNF-α) and interleukin-1β (IL-1β) also play important roles in the development of periodontitis. Interleukin-37(IL-37), which is a newly discovered cytokine in the IL-1 family, has five shear variants from a to e, among which the clover β-structure encoded by exon 4 plays an important role in the binding of cytokines and the corresponding receptors. IL-37 has strong anti-inflammatory and inhibition of autoimmunity, can enter the nucleus with the help of caspase-1 and bind with Smad proteins to regulate the transcription of pro-inflammatory genes. Extracellular IL-37 can bind to IL-18 binding protein and inhibit the production of pro-inflammatory factors. IL-37 can inhibit the progression of periodontitis by inhibiting the RANKL signaling pathway, inhibiting the proliferation and differentiation of dendritic cells and CD4+T cells, binding to Smad proteins, and releasing pro-inflammatory factors such as IFN-γ and TNF-α. The IL-37 concentration in periodontal tissue can indicate the progression of periodontitis. Few studies have described the interaction between the anti-inflammatory factor IL-37 and periodontitis. Thus, in this paper, the structure and function of IL-37 and the related factors between IL-37 and periodontitis will be reviewed.
Resin-modified glass ionomer cement (RMGIC) has good physical, chemical and biological properties and is suitable for the treatment of deciduous caries, aged root surface caries and wedge-shaped defects. Surface treatment is a common method to improve bonding strength, which can improve physical and chemical retention between different components. This paper mainly introduces the current research status of the influence of different dentin surface treatment methods on the bonding strength of RMGIC. At present, the common dentin surface treatment methods are pretreatment, acid etching, laser treatment, etc. The pretreatment agent can improve the bond strength of RMGIC by increasing the surface area and porosity of dentin. The bond strength of RMGIC could be effectively improved after the dentin was treated by an acid-etching bonding system. The dentin was treated with a laser to obtain a higher bonding strength. However, whether the use of resin adhesives will affect the release of fluoride ions in RMGIC into the deep dentin and thus affect the repair effect also needs further research.
Occlusal disorder is an abnormal condition in which the static and dynamic relations between the upper and lower teeth are not well aligned . The most common occlusal disorder in clinical practice is the inability to reach the intercuspal position due to early contact of individual points or occlusal interference due to occlusal high points, which can lead to periodontal tissue damage, decreased masticatory function, temporomandibular joint and muscle discomfort; these results can occur through the overactivation of the locus coeruleus-sympathetic-adrenal medullary system and hypothalamic-pituitary-adrenal axis induce elevated serum corticosteroid levels, which leads to chronic stress in the body. This article reviews the effects of chronic stress caused by occlusal disorder on bone tissue, stomatognathic system, emotional health and cognitive function. It has been found that occlusal disorders not only result in the loss of bone in the oral cavity, the reduction of bone mass in the whole body and damage to the local function of the stomatognathic system but also negatively affect the body’s anxiety, sleep, cognitive function and spatial memory ability as a result of the neuroendocrine changes . In recent years, concern about occlusal disorders has been on the rise. Early detection and timely adjustment of uncoordinated occlusion has become an issue that cannot be ignored in the clinic.
Oral cancer is one of the most common cancers that occur in the head and neck and can seriously affect the life span and living standard of oral cancer patients. Candida albicans （C. albicans） is the most common opportunistic pathogenic fungus in the oral cavity, shows pathogenicity and easily causes Candida infection when the host′s immune function is low. Recent studies have shown that C. albicans infection is closely related to oral cancer. This paper reviews the epidemiology of C. albicans infection in oral cancer patients, the influence of C. albicans infection on the occurrence and development of oral cancer and research on its mechanism. Existing studies have shown an increased risk of C. albicans infection in oral cancer patients, while C. albicans infection may promote the occurrence and development of oral cancer through mechanisms such as damaging the oral epithelium; producing carcinogens, including nitrosamine and acetaldehyde; and inducing a chronic inflammatory response and T helper cell 17 immune response. However, these mechanisms are still relatively superficial and lack sufficient direct evidence. In the future, additional in-depth studies are still needed to further clarify the cancer-promoting mechanisms of C. albicans and provide new ideas for the prevention and treatment of oral cancer.
The jaw and femur are commonly used sites in basic research for modeling bone defects or inserting implants. An increasing number of studies have identified that the jaw and femur indeed show great differences in embryonic development and growth, histomorphology and bone metabolism. A literature review showed that, compared with the femur, the main osteogenic pathway of the jaw may have better osteogenic ability, and its stem cells have better proliferation and osteogenic differentiation ability. However, the jaw structure is less regular, the osteogenic differentiation ability of its osteoblasts is mineralization slightly weak, and the immune cells of the jaw are more sensitive to cytokines. These may be the reasons why the osseointegration of the jaw implant is different from that of the femur in animal experiments, but its specific mechanism has not been clarified.
In recent decades, although great progress has been made on the diagnosis and treatment of oral squamous cell carcinoma (OSCC), its 5-year survival rate has not been significantly improved. The basic reason is the unclear pathogenesis, lack of effective molecular markers for assessing invasion, metastasis, and recurrence as well as therapeutic targets. The present view is that genetic and epigenetic abnormalities are related to the occurrence and development of OSCC. Epigenetic inheritance is a biological behavior that can be regulated and reversed, and it plays an important role in the occurrence and development of malignant tumors. First, this review will describe the role of epigenetic modifications in the development of OSCC in combination with our research and the latest research progress of epigenetics, including DNA methylation, RNA methylation, short noncoding RNAs (miRNAs, etc.), long noncoding RNAs, circular RNAs, histone modifications (acetylation and methylation), chromatin remodeling and genomic imprinting. Then, we will analyze the value of epigenetic studies in the prevention, diagnosis, and targeted therapy of OSCC.
Cyclophilin A (CypA) is the first foldable enzyme in human cells that has peptidyl proliferase-trans isomerase activity and has a strong proinflammatory effect. CD147 can act as the signal receptor of CypA. The interaction of the two through cell-surface heparin binding activates extracellular regulated protein kinases (ERK1/2) and nuclear factor kappa-B (NF-κB) signaling pathways in macrophages and increases the expression of MMPs and other inflammatory factors. The CypA/CD147 interaction regulates inflammation, promotes the inflammatory response and bone resorption and is involved in the pathological processes of a variety of systemic diseases. CypA and CD147 may take part in the chemotaxis of inflammatory cells, increase white blood cell infiltration in tissues, and increase CypA and CD147 expression in periodontitis gum tissue and gingival groove liquid with inflammation, prompting their interaction to promote the progression of periodontitis. However, the specific function of the signaling pathways in the periodontitis mechanism still requires further elucidation.
Contemporary endodontic microsurgery has emerged as a significant treatment modality in the retention of teeth with persistent apical periodontitis. This article proposes the concept of the full-cycle clinical management of endodontic microsurgery based on the condition of the patient and tooth, attempting to develop a comprehensive strategy for the examination, treatment and follow-up to save natural teeth. Full-cycle clinical management included preoperative consideration of the general condition and surgical site and selection of cases for endodontic microsurgery; intraoperative application of techniques such as lasers, "bone window" technique and targeted endodontic microsurgery to make the surgical approaches more varied and the operation minimally invasive; postoperative outcome assessment according to the history, clinical and radiographic examination; and analysis of the short- and long-term outcomes.
Oral submucous fibrosis (OSF) is a chronic disease that produces scars, tissue fibrosis, and precancerous lesions. Epidemiological studies have shown that chewing betel nut is the most significant risk factor for OSF. Many studies have also indicated that habits such as chewing and smoking tobacco and drinking alcohol increase the risk of OSF, which is widely recognized as an oral precancerous lesion or a potentially malignant oral disorder. Pathological characteristics include chronic inflammation, excessive collagen deposition in the connective tissues below the oral mucous epithelium and local inflammation in the lamina propria or deep connective tissues. OSF patients have a 7%~30% chance of developing oral cancer. Submucosal local injection of triamcinolone and tanshinone was mainly used for the treatment of oral submucosal fibrosis. This treatment improves mouth opening and alleviates the burning sensation in OSF, and the treatment efficacy was as high as 93%. The article will discuss the occurrence, development, diagnosis and treatment of oral submucous fibrosis for clinical management by the medical community.
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