Severe tissue defects in the oral and maxillofacial region are commonly caused by tumor resection and trauma and can impair physiological function and aesthetics in patients. Applying a soft-tissue free flap transfer may avoid exposing important blood vessels and nerves and restore basic anatomical structures and facial features. However, the outcomes of soft-tissue free flap transfer have tended to be unsatisfactory because of the exquisite anatomical structure and complicated functions of the oral and maxillofacial region. Therefore, it is clinically important to choose a proper reconstructive method based on specific tissue defects and to optimize the processes involved in the designing and harvesting of soft-tissue free flaps. In this review, we summarize the application of soft-tissue free flaps in oral and maxillofacial defects and strategies for optimizing the quality of tissue reconstruction.
Oral lichen planus (OLP), a common and chronic disorder, has no effective treatment or cure because its etiology is complicated and has until now remained unclear. Therefore, effectively controlling the activity of the disease and preventing its recurrence are two primary purposes of clinical treatment for OLP. The available evidence supports the notion that topical steroids are the preferred drug for treating this disease. However, some cases have poor clinical curative responses to steroids or other medicines, mainly because of drug resistance and other factors. Therefore, scholars have explored new drugs and methods with the aim of achieving more effective and safe treatment effects. The current research evidence indicates that glucocorticoid remains the front-line drug for OLP treatment. Topical tacrolimus, pimecrolimus and retinoic acid combined with glucocorticoid can be used as alternative therapies, especially in cases with glucocorticoid drug resistance. The systemic application of glucocorticoid or immunosuppressive agents, such as methotrexate, mycophenolate mofetil, and sulfoxide, should be limited to extensive, refractory cases or those with lesions involving regions outside the oral cavity. Surgery and cryotherapy can be applied in a specific, limited range of lesions. Some previous randomized controlled clinical studies have had limitations, including a small sample size, short treatment and clinical follow-up periods, a lack of reliable questionnaires and differences in evaluation standards. Therefore, future studies should include the following: randomized controlled clinical studies with large sample sizes that offer reliable evidence of a curative effect; assessments of treatment outcomes should be extended as long as possible; the follow-up period should be long enough to assess the recurrence rate; and the methods and standards used to evaluate treatment effects should be standardized.
Objective To investigate the current status of gingival bleeding and dental calculus in the 12- to 74-year old population in Guangdong Province with the aim of providing information to support oral health care. Methods A stratified, multistage, random sampling design was used to obtain 7 provincially representative sample groups consisting of 8, 544 Guangdong residents aged 12, 13, 14, 15, 35-44, 55-64 and 65-74 years old with a 50/50 gender ratio. The status of gingival bleeding and dental calculus in the whole mouth was assessed according to the Guidelines of the Fourth National Oral Health Survey using a CPI probe. The resulting data were analyzed using the SAS9.2 package. Results The prevalence of gingival bleeding in residents aged 12, 13, 14, 15, 35-44, 55-64 and 65-74 years old was 43.75%, 42.76%, 49.06%, 39.38%, 81.94%, 90.97%, and 84.03%, respectively, while the average number of teeth with gingival bleeding per person was 1.95, 2.07, 2.59, 2.39, 9.62, 10.36, and 9.98, respectively. In the 12-, 13-, 14-, and 15-year-old groups, peak prevalence was observed at age 14 (P < 0.05). In the 35-74-year-old group, the prevalence and mean number of teeth with gingival bleeding per person increased with age, and both parameters reached a peak in the 55-64-year-old group. The prevalence of dental calculus in the 12-, 13-, 14-, 15-, 35-44-, 55-64- and 65-74-year-old group was 40.57%, 41.09%, 45.05%, 54.84%, 98.96%, 97.22%, and 92.01%, respectively, and on average, each person had 1.61, 1.71, 2.14, 3.52, 20.30, 20.55, and 17.26 teeth, respectively, with dental calculus. The prevalence and mean number of teeth with dental calculus increased with age. In the 35- to 74- year-old group, the prevalence of dental calculus was higher in urban areas than in rural areas and the mean number of teeth with dental calculus was higher in males than in females. Otherwise, there were no significant differences in the prevalence or the mean number of teeth with dental calculus or gingival bleeding between urban and rural areas or between males and females. Conclusion There is a high prevalence of both gingival bleeding and dental calculus in all 7 age groups in Guangdong, indicating that poor oral hygiene and gingival inflammation are common in Guangdong Province.
Objective To investigate the effect and potential molecular mechanisms of isorhamnetin (ISO) extracted from Ginkgo biloba on the differentiation of osteoclasts. Methods Osteoclast precursor RAW264.7 cells were induced with RANKL to differentiate into mature osteoclasts. Different concentrations of ISO were added to RAW264.7 cells to determine its effect on osteoclast differentiation. CCK8 was used to evaluate the effect of ISO on cytotoxicity. The impact of ISO on the osteoclast differentiation process was investigated by analyzing tartrate resistance and bone resorption lacuna. Real-time PCR was performed to analyze the levels of differentiation marker genes, including tartrate resistant acid phosphatase (Trap), cathepsin K (Ctsk), and matrix metalloproteinase 9 (MMP-9); differentiation-related transcription factors, including the proto-oncogene protein c-Fos, nuclear factor of activated T-cells cytoplasmic 1(NFATc1); and the levels of downstream NF-κB p65 signaling pathway phosphorylation. Using the above-described method, we verified that ISO exerted an inhibitory effect on osteoclast differentiation and explored related molecular mechanisms. Results Different concentrations of ISO (1-10 μM) had no cytotoxic effects on RAW264.7 cells, inhibited TRAP activity and decreased the number of bone resorption lacuna during osteoclast differentiation. When applied at a concentration of 10 μM, its inhibitory effect was significant. In addition, ISO significantly reduced the expression levels of Trap, Ctsk, MMP-9, c-Fos, NFATc1 and NF-κB p65 mRNA. Conclusion ISO extracted from Ginkgo biloba extract exerted an inhibitory effect on osteoclast differentiation, and the mechanism underlying its activity may involve the inhibition of the classical NF-κB pathway.
Objective To explore methods using modified tissue enzymatic separations for culturing primary hDPSCs in vitro and further identify the cells produced. Methods Primary hDPSCs were cultured using the modified tissue enzymatic separation method, and cells were identified by morphology, cell surface markers, and differentiation potential and evaluated using flow cytometry and growth curves. Results The hDPSCs were successfully isolated using the modified tissue enzymatic separation method. The morphology of these cells was similar to that of fibroblasts and mesenchymal stem cells, and the growth curve was "S" -type. The results of cell phenotype analysis indicated that the cells were positive for surface markers of mesenchymal stem cells, including CD29, CD44, and CD90, and negative for markers of hematopoietic stem cells, including CD34, CD45, and CD106. The cells were capable of differentiating into multiple cell types. Conclusion The modified tissue enzymatic separation method can successful be used to culture primary hDPSCs in vitro.
Objective To study the clinical periodontal status of patients with desquamative gingivitis (DG) and analyze the factors that influence clinical periodontal indicators. Methods A purposive sampling method was used to obtain 42 subjects for a DG case group and a control group. Periodontal clinical indicators were detected, and related factors were analyzed. Results The DG patients were primarily middle-aged women. Periodontal clinical indicators were more prevalent in individuals with oral lichen planus (OLP) and mucous membrane pemphigoid (MMP) than in the control group. Probing depth (PD) (χ2=53.058, P<0.001; χ2=32.989, P<0.001), clinical attachment (χ2=30.292, P<0.001; χ2=32.470, P<0.001) and the positive rate of bleeding on probing (BOP) (χ2=50.003, P<0.001; χ2=36.236, P<0.001) were higher in the OLP and MMP group than in the control group. The time interval between the onset and treatment of DG was correlated with PD (rs=0.523, P<0.001) and the rate of positive BOP sites (rs=0.377, P=0.014). Conclusion Patients with DG have obvious periodontal lesions. Early medical intervention is helpful for diagnosing and treating DG-related oral and systemic disease.
Objective To evaluate the spatiotemporal relationship between the root apex of mandibular molars and the inferior alveolar nerve canal (IANC) in adults. Methods Cone-beam computed tomography (CBCT) images were collected in 236 patients, and the distances from the root apexes of mandibular molars to the IANC were measured in NNT 4.6 software. The relationship between distance and gender was evaluated. Results In two-rooted mandibular first molars, the distances from the mesial root and distal root to the IANC were 7.34 ± 2.07 mm and 6.69 ± 2.08 mm, respectively, in males and 6.47 ± 2.22 mm and 5.94 ± 2.11 mm in females. In three-rooted mandibular first molars, the distances from the mesial root, distobuccal root, and distolingual to the IANC were 7.29 ± 1.30 mm, 7.40 ± 2.33 mm, and 9.97 ± 2.19 mm, respectively, in males and 6.08 ± 2.57 mm, 6.35 ± 2.40 mm, and 9.01 ± 2.90 mm, respectively, in females. In one-rooted mandibular second molars, the distance from the root to the IANC was 4.09 ± 1.64 mm in males and 3.89 ± 1.76 mm in females. In two-rooted mandibular second molars, the distances from the mesial root and distal root to the IANC were 5.14 ± 2.08 mm and 4.39 ± 1.85 mm, respectively, in males and 3.78 ± 1.69 mm and 3.24 ± 1.72 mm, respectively, in females. There were no significant with in-gender differences between the left and right side in the distances from the root apexes to the IANC (P>0.05). The distances from the mandibular first molar were greater in males than in females. The longest average distance was from the distolingual root apexes of three-rooted mandibular first molars to the IANC, and the distances were longer from the distobuccal root apexes of three-rooted mandibular first molars to the IANC than from the distal root apexes of two-rooted mandibular first molars to the IANC (P<0.05). There was no within-gender difference in the distances from the root apexes of single-rooted mandibular second molars to the IANC (P>0.05), but the distances in two-rooted mandibular second molars were larger in males than in females (P<0.05). The distances from the root apexes to the IANC were smaller in mandibular second molars than in mandibular first molars (P<0.05). Conclusion There are significant differences between adult males and females in the distance from the root apex to the IANC for mandibular first molars and two-rooted mandibular second molars. The distances from the root apexes to the IANC were smaller in mandibular second molars than in mandibular first molars.
Objective To measure and compare condyle-related indexes(volume, surface area, anterior space, upper space and posterior space) in adult female patients with different sagittal malocclusions with the aim of providing a reference for clinical treatment. Methods The CBCT database of Qingdao Stomatology Hospital was searched to identify patients with high-angle adult skeletal malformations with the following classifications: classⅠ(n=30), class Ⅱ(n=30), and class Ⅲ(n=30). The CBCT images associated with the sample population were stored according to DICOM3.0 medical digital image communication standards. Mimics10.01 software was used to read and prepare three-dimensional reconstructions of the condylar, and the above-listed indicators were measured and statistically analyzed. Results There were no significant differences between the right and left sides among the three groups (P > 0.05). For parameters including condylar anterior joint space and post-joint space, the differences among the three groups were significant (P < 0.05). There was no significant difference in parameters related to condylar articular space between classⅠand class Ⅱ(P > 0.05). The differences between skeletal classesⅠand Ⅲ and between skeletal ClassesⅡ, and Ⅲ were statistically significant (P < 0.05). Conclusion Condylar position varies among high-angle adult woman with skeletal malocclusions with different sagittal skeletal patterns.
Objective To assess family environmental factors that impact caries in children during a follow-up study for family-based community oral health promotion models. Methods This study was conducted from June to December 2015. A total of 200 households were selected from Jinzhou community in Nanning with the random sampling method. The data were collected through oral examinations and questionnaire surveys of family members. A logistic regression model was used to analyze the relationship between family environment factors, such as socioeconomic and family-related behaviors, and caries in children. Results After adjustment for confounding factors, families in which more than 1, 000 mL of sugar drinks were purchased per month; those in which the family members had a low frequency of brushing (occasionally or not); those in which the mother had a high frequency of drinking sweet drinks (more than one time each day), brushed with low frequency (less than 2 times), had no regular oral examination in the past year, or had low scores in oral health attitude and knowledge; those in which the father/mother had a low level of education (short-cycle courses and under); and those with a low annual household income (less than 50, 000 RMB) had children with high rates of dental caries. Families purchasing sugar drinks >1 000 mL per month were 2.22 times more likely than families purchasing sugar drinks ≤1 000 mL per month to have caries in children. Conclusion Family environmental factors exert a certain influence on children's caries, and this information is a useful reference for a follow-up study.
Conventional root canal therapy can not completely treat all periradicular lesions, especially combined endodontic-periodontic diseases, large periapical lesions and bone defect lesions. Guided tissue regeneration greatly improves the success rate of endodontic surgery in treating these lesions. This article focuses on the application of various grafting materials, guided bone regeneration membranes and regulatory factors in endodontic surgery.
The pathogenic mechanisms by which oral microbial communities affect the occurrence and development of dental caries remain unclear. Applications that make use of high-through put sequencing technologies and metaomics approaches to research dental caries etiology can provide new ideas about disease prevention and treatment. In this article, we review advanced research presented in metaomics studies, including genomic, metagenomic, metatranscriptomic, metaproteomic and metabolomics studies of dental caries.
Because nanoparticles have particular characteristics, such as small size and surface effects, nano-TiO2 is widely used in air purification, wastewater treatment and self-cleaning. In recent years, TiO2 photocatalysis has thoroughly explored as a new titanium implant surface treatment method. Photocatalytic performance is better for TiO2 nanowires than for nano-TiO2 particles. Hence, these nanowires have received widespread attention with regard for their more specific surface area and surface energy, improved charge carrier transport efficiency, and enhanced charge collection efficiency. Photon-generated carrier transport moves in a one dimensional straight path along a nanowire, and this could decrease photoelectron loss. In this paper, we summarized the principles underlying, factors that influence, and applications involving TiO2 nanowire photocatalysis. Additionally, we describe its method of preparation and toxicity.
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