Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a class of disease due to complications of long-term use of bisphosphonates drugs such as zoledronic acid, phosphoric acid, etc. It is mainly manifested in the mouth as a result of tooth extraction or appearing spontaneously mandibular long-term healing wounds, sequestrum exposure, local soft tissue swelling with pain and pus, etc. The X-ray showed irregular bone destruction and bone sclerosis as the lesions progress. At present, the diagnosis and treatment of the disease has not reached agreement. In this paper, clinical diagnosis and treatment on BRONJ in recent years were reviewed.
Objective To investigate the expression of Notch signaling molecules in temporomandibular joint arthritis (TMJOA), and to explore the role and mechanism of Notch signaling pathway in the development and progression of TMJOA. Methods 72 Kunming mice were randomly divided into experimental group, sham-surgery group and normal group. In experimental group, discs on the right TMJ were subjected to total discectomy, sham-operation group underwent the same procedure without disc removal, while normal group serve as blank control. All the left temporomandibular joint discs were not treated. 8 mice in each group were sacrificed respectively at 1 week, 2 week, 4 week after surgery. Histological examinations were performed to assess success of TMJOA model, according to the pathological standard of osteoarthritis diagnosis. Immunochemistry techniques were performed in the successful TMJOA cartilages to evaluate the expression levels of Notch1 (NICD1), Jagged1, Hes1 and Hes5. The scores were evaluated by semi-quantitative method. Results Notch1 (NICD1), Jagged1 and Hes5 were activated in the experimental group with the expression levels increased dramatically over time. While Hes1 expression was suppressed at the beginning of osteoarthritis but was up-regulated afterwards. Conclusion Notch pathway-related molecular expression changed greatly in TMJOA model, indicating that the pathway in the occurrence and development of TMJOA plays an important role.
Objective To analyze the role of TLR4 in innate immune response of dental pulp by comparing the locations and expressions of TLR4 in healthy dental pulp tissue and dental pulp tissue affected by deep caries. Methods Healthy teeth and teeth affected by deep caries were demineralized and stained with hematoxylin and eosin (HE) to observe the morphology of dental pulp. Immunohistochemistry staining was performed to observe the expressions of TLR4. Results Observed under HE staining, dentin tubules of teeth affected by deep caries were damaged with a lot bacteria mass. The expression of TLR4 were located in the odontoblast layer and near the blood vessels in both groups. Positive staining of TLR4 in deep caries pulps (2.10±0.74) were significantly higher than that in healthy teeth (1.25 ±0.46). Conclusion Expression of TLR4 in deep caries pulp is stronger than that in healthy pulp. It suggests that TLR4 may play a role in the innate immune response of deep caries.
Objective To analyze the stress difference of alveolar bone around the abutment and alveolar ridge of edentulous of three different kinds of root-attachment-supported overdenture under different load conditions, in order to provide a reference for the choice of clinical root attachment. Methods The occlusal force of overdenture was simulated by electrical resistance strain measurement in vitro. The stress of the alveolar bone, the central part of the mandibular arch and the first molar correspond to the alveolar ridge were measured. The stress difference of 3 kinds of attachment overdenture under different loading conditions were compared and analyzed. Results Under the same loading condition, all three kinds of overdentures had a certain degree of slip of the denture (magnetic attachment denture) or rotation (3 kinds of attachment dentures). The abutment neck in different parts of the dental arch and alveolar bone, anterior free end edentulous alveolar ridge stress distribution was significantly different. Conclusion ERA attachment overdenture was the most preferable, followed by the magnetic attachment overdenture. Suitable attachment should be selected based on specific clinical cases.
Objective To study the effect of the edentulous arch with implant supported telescopic overdenture. Methods Fifteen patients with edentulous jaws underwent telescopic overdenture restoration. A total of 26 prostheses were fabricated (11 in the upper jaws, 15 in the lower jaws) with 104 placed implants. The secondary crown was fabricated by wax-lost cast method. Clinical examination and radiographs were conducted. Changes in the marginal bone level around the implants were evaluated by radiograph. The satisfaction level of complete denture and implant-supported overdenture were compared. The mean follow-up time was 32 months (range 6-60 months). Results Twenty-six prostheses showed better stability, maintenance and occlusion. There were statistical differences between complete denture and implant-supported overdenture in comfort level and chewing function. 1 mm bone lost was found in two patients after 4 years. No implant was lost during the loading time. Conclusion The preliminary clinical results of this research showed that implant supported telescopic overdentures were reliable for edentulous patients.
Objective To provide some references of using miniscrew implants in clinical orthodontic treatment, the bone thickness of maxilla and mandible of different vertical facial type in adults with cone-beam CT (CBCT) was measured. Methods 57 scanned patients were selected as subjects. Among them, 20 were included in the high-angle group, 22 in the normal-angle group, and 15 in the low-angle group. On volumetric images, we measured the buccal and palatal cortical bone thickness of maxilla, the buccal cortical bone thickness of mandible from canine to the second molar teeth at heights of 4.0 mm from cemento-enamel junction (CEJ). The mean of cortical bone thickness was compared between three groups.Results There were statistical differences among three different vertical facial groups in the cortical bone thickness (P<0.05). The high-angle group has the thinnest cortical bone while the low-angle group has the thickest. Conclusion Clinicians should be aware of the probability of thin cortical bone plates and the risk of miniscrew implant failures at maxillary posterior miniscrew implant sites in high-angle patients.
Objective To explore the method of apically positioned flap technique (APFT) on buccal keratinized gingiva reconstruction around dental implants and evaluate its clinical outcomes and technical characters. Methods 13 patients, who were insufficient of buccal keratinized gingiva around dental implants but sufficient with alveolar ridge crest tissue or palatal tissue at posterior maxillar, were enrolled in this study. APFT was operated during the phase Ⅱ surgery, by which some tissues were transferred from the alveolar ridge crest or palatal side to the original site of keratinized gingiva. Before APFT surgery and 1, 6 and 12 months after crown restoration, the width and thickness of transferred tissues were measured, gingival index (GI) and bleeding on probing (BOP) were also detected. The results were applied to comparative t-test statistical analysis. Results Transferred tissues by APFT showed healthy one month after crown restoration and exhibited characters of keratinized gingiva compared with the adjacent teeth at 6 and 12 months after restoration. Mean value of width of transferred tissue were respectively (3.25 ± 0.40) mm, (3.04 ± 0.34) mm and (2.97 ± 0.32) mm, meanwhile the thickness were respectively (2.05 ± 0.20) mm, (1.91 ± 0.23) mm and (1.84 ± 0.25) mm. The value of width and thickness of the adjacent teeth gingiva were (3.19 ± 0.42) mm and (1.96 ± 0.23) mm respectively. No significant differences were found between transferred tissue and adjacent teeth gingiva on width and thickness (P>0.05). Observation results of GI and positive rate of BOP of transferred tissue were also similar to which of gingiva of the adjacent teeth. Conclusion Technique of apically positioned flap is an effective measure on buccal keratinized gingiva reconstruction.
Objective To observe the clinical effect of microscopic periapical surgery combined with (mineral trioxide aggregate (MTA) apical filling in treatment of chronic apical periodontitis. Methods A total of 64 patients with 91 teeth of chronic apical periodontitis, which couldn't be treated with root canal treatment, were selected and randomly assigned into two groups. 32 patients with 43 teeth in the control group were treated with traditional surgery combined with amalgam filling. 32 patients with 48 teeth in the experimental group were treated with microsurgical apical surgery combined with MTA apical filling. Patients were followed for 12 months. The healing of periapical lesionwere assessed by clinical symptoms and X-ray examination every three months. Results In the experimental group, 27 cases cured, 17 cases improved, the success rate was 91.67% (44/48). In the control group, 19 cases cured, 12 cases improved, the success rate was 72.09% (31/43). The success rate in experimental group was significantly higher than the control group (χ2 = 5.997, P = 0.014). Conclusion Effect of microscopic periapical surgerycombined with MTA apical filling in treatment of chronic periapical periodontitis is satifactory.
Objective To know the influencing factors of dental caries in first permanent molars among children aged 10-12 years old in Guangzhou, and to give references for dental caries prevention. Methods The samples were selected by stratified random sampling method. Oral health examination and questionnaires were applied to all the 18 656 children who were 5 or 6-grade in 149 primary schools. Results The prevalence of dental caries in first permanent molars was 18.19%. Girls accouted for 19.96%, which was significantly higher than that of boys (16.71%) (χ2 = 32.817, P< 0.001). Multiple regression analyses were used to investigate the influencing factors of dental caries in first permanent molars. After controlling school cluster and other factors, household register, gender, pit and fissure sealant, consumption of sweets and chocolates, consumption of sweet milk were influencing factors of permanent teeth caries. And household register, gender, pit and fissure sealant, consumption of sweets and chocolates were associated with mean DMFT. Conclusion school oral health education should focus on the consumption of sugars and cares should be put into the differences between urban and rural area. In addition, strengthening publicity of the sealant retention project,raising public awareness, and improving sealant retention quality are necessary to ensure the anti-caries effect.
Objective To analyze the correlation between stage of oral disease and the transformation of children dental anxiety in first visit. Methods Children aged 45 to 74 months (13.7~6.2) years old with molar caries in the first visit were selected and divided into three groups: the acute stage group, the non-acute stage group, and the conventional examination group. The face version of the modified child dental anxiety scale (MCDASf) was used to evaluate the changes of anxiety before and after treatment. Results The data of correlation among 3 groups about dental anxiety showed a statistical difference (χ2 = 9.132, P = 0.010). Compared with acute stage group and non-acute stage group, a statistical significance in dental anxiety can be found (P<0.012 5). There was no correlation between anxiety prognosis and gender (P>0.05). Conclusion The occurrence and transformation of dental anxiety in children varied with different stage of oral disease. Dental anxiety can be improved significantly by appropriate therapy and behavior management.
Calcium hydroxide is widely used as disinfectant of root canals recently. The vehicle is a substance which is added into calcium hydroxide to form a paste. It can be classified into water soluble, viscous and oily. Different vehicles for calcium hydroxide may produce different disinfectant effects. Searching for an ideal vehicle for calcium hydroxide is a hot research topic in recent years. This article will make a review on progress in the study of calcium hydroxide in different vehicles.
With many advantages such as safety, effective cutting of enamel and dentin, Er, Cr: YSGG laser has gained more and more attention in recent years. After irradiation, the morphology, composition, and structure of tooth surface has changed, yet, the effect of these alterations to the bonding strength of the subsequent material is controversial. The paper has made a review from the following four aspects: Mechanism for tooth hard tissue cutting with Er, Cr: YSGG laser; The structure characteristics of primary teeth; The enamel bonding strength of primary teeth after Er, Cr: YSGG laser treatment; Safety, superiority and expectation for the application of Er, Cr: YSGG laser in primary teeth.
Sleep bruxism is a common disease clinically, which has serious impacts on human's masticatory system, endangers patient's physical and mental health. Because of the complicated and unclear pathogenesis, no recognized effective cure of sleep bruxism has been carried out. This review isabout the studies of sleep bruxism treatment in recent years, in order to provide the reference for clinical work.
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