To seek convenient and effective method for reconstruction of edentulous jaw, Maló and his colleagues developed All-on-Four implant immediate-function concept. The principle of All-on-Four is to support the full-arch prosthesis by 4 implants and to achieve immediate loading after surgery. Its advantages include avoiding additional bone grafting, evading critical anatomical structures and immediate prosthesis. In recent years, All-on-Four technique has been widely utilized in clinical practice as a viable approach for edentulous patients. With the auxiliary of guided surgery and biomechanical researches, All-on-Four has achieved predictable clinical results. In this paper, the development, investigation of biomechanics and main points of surgery and prosthesis of All-on-Four were briefly reviewed.
Objective The aim of this study is to investigate the roles of Notch signaling and autophagy on mineral trioxide aggregate (MTA) induced differentiation of human dental pulp cells (hDPCs). Methods Third molars from healthy human were collected and hDPCs were isolated by a combined digestion of collagenase Ⅰ and dispaseⅡ. Real time PCR were used to test the mRNA expression levels of alkaline phosphatase (ALP), runt-related transcription factor 2 (Runx2) and dentin sialophoprotein (DSPP) in MTA treated hDPCs in different time (24 h, 3 d and 7 d). The mineralization nodules formed by hDPCs with or without MTA treatment were detected by Von Kossa staining. Expressions of Notch1, Jagged1, Hes1, LC3Ⅱ/LC3 Ⅰand p62 in wild type and MTA treated hDPCs were detected by western blotting. Results MTA extracted in a concentration of 0.1 mg/mL could promote the differentiation of hDPCs. Compared with that of wild type hDPCs, the expressions of Notch1, Hes1, or Jagged1 and p62 (P<0.01) in MTA treated hDPCs were significantly increased. MTA treatment showed inhibition effects on autophagy flux similar to Bafilomycin A1, a specific inhibitor of fusion between autophagosomes and lysosomes. Conclusion MTA could promote hDPCs differentiation with highly relevant in stimulating Notch1-Jagged1-Hes1 signaling and inhibition of autophagy flux.
Objective Explore the role and status of tumor necrosis factor receptor-associated factor 6 (TRAF6) in the inflammatory response of human osteoblast-like cells MG63 which was triggered by Enterococcus faecalis (E. faecalis) and its lipoteichoic acid (LTA). Methods SiRNA technology was applied to silence the TRAF6 gene of MG63 cells, Using E.faecelis and its LTA to stimulate the silence MG63 cells with different hours. After that, using real-time PCR technology to detect toll-like receptor 2 (TLR2) and TRAF6 gene expression and using ELISA assay to detect proinflammatory cytokines interleukin-1β and TNF-alpha expression levels.Results When MG63 cells was infected by E. faecalis, its LTA, TLR2 and TRAF6 gene level has increased to varying degrees (P< 0.05); interleukin-1β and TNF-alpha expression was significantly higher (P< 0.05). When TRAF6 gene of MG63 cells was silenced by siRNA, pro-inflammatory cytokines interleukin-1β, interleukin-6, interleukin -8 and TNF-alpha expression decreased significantly (P< 0.05). Conclusion E. faecalis and its toxic components is identified by MG63 cells mainly through TLR2 receptors. The major virulence factor in periapical infections caused by E. faecalis is LTA.
Objective To evaluate the efficacy of Mtwo rotary instruments during root canal retreatment. Methods Thirty mandibular premolars with oval root canal were prepared with ProTaper rotary instruments and obturated with lateral condensation method. The samples were divided into 2 groups. In Mtwo group, the filling materials were removed with Mtwo retreatment system and Mtwo basic instruments. Inmanual stainless group, the filling material were removed with manual instruments. The percentage of residual filling material was measured with image proplus software and the operating time was recorded. Results The percentage of residual filling material in Mtwo group was significantly lower than manual group in middle third, but the opposite result can be found in the coronal third. In the whole canal, no significant difference was found between the two groups. The mean operating time in Mtwo group was significantly shorter than manual group. Conclusion Mtwo rotary instruments can shorten the time of retreatment, neither of the groups can remove the filling material in oval root canal completely.
Objective To evaluate the therapeutic effects of erbium-doped: yttrium aluminium garnet laser (Er: YAG laser) combined with guided bone regeneration (GBR) in the treatment of peri-implantitis bone defect. Methods A total of 26 implants in 15 patients with peri-implantitis were selected and divided into experimental group (14 implants) and control group (12 implants) randomly. The experimental group was treated with Er: YAG laser combined with GBR, and the control group was treated with mechanical curettage with GBR. Clinical periodontal index test including plaque index (PI), sulcus bleeding index (SBI), probing depth (PD) and clinical attachment level (CAL) were checked at baseline, 3 months and 6 months. All the above data were statistically analyzed. Results All of the clinical periodontal index were improved after surgery. SBI, PD and CAL of the experimental group was 0.8 ± 0.2 mm, 5.8 ± 0.8 mm, and 2.3 ± 0.7 mm, while they were 1.1 ± 0.2 mm, 6.2 ± 0.6 mm, and 3.6 ± 0.6 mm in the control group. The experimental group showed better results than the control group (P< 0.05), while PI showed no difference between the 2 groups (P> 0.05). Conclusion The combined application of Er: YAG laser and GBR in the treatment of bone defect in peri-implantitis has good clinical effects.
Objective To evaluate the accuracy of digital surgical guide in tilted implant in the maxillary posterior region.Methods Jaw data from 14 patients were scanned using cone beam computed tomography (CBCT), and digital models were acquired by scanning maxillary plaster models. Implant software was employed to process jaw data and digital models in order to design the surgical template. Then the stereolithographic (SLA) surgical template was created to guide the surgery. After that CBCT data was collected again and compared with the data collected before. Deviations between the actual implant position and the planned implant position were analyzed. Results Central deviation at the hex and apex between the actual implant and the planned implant was almost constant with a mean of (0.625 ± 0.183) mm and (0.820 ± 0.208) mm. Mean value of horizontal deviation at the hex was (0.314 ± 0.070) mm, horizontal deviation at the apex was (0.509 ± 0.139) mm, vertical deviation at the hex was (0.538 ± 0.178) mm, vertical deviation at the apex was (0.638 ± 0.178) mm. Conclusion Angled implantation in the maxillary posterior region can reduce risks and trauma as well as the difficulties and duration of surgery. However, our data suggested that significant deviations existed in the actual implant position and the planned implant position.
Objective To evaluate the application effect of the platform switching implants in maxillary anterior region, to explore the effect of platform switching technology on the surrounding tissues. Methods 55 patients with 60 single maxillary anterior implants were divided into two groups: platform-switching implants group (Ankylos), 25 patients with 28 implants; butt-joint implants group (Nobel Replace), 30 patients with 32 implants. The patients received follow-up care more than 1 and 2 year after the final setting of the prosthesis, at which time periapical radiographs were taken. The marginal bone level around the implant and Pink Esthetic Score (PES) were measured for comparison. Results The average marginal bone changes of platform-switching implants after 1 year and 2 year were (-0.41 ± 0.36) mm and (-0.55 ± 0.33) mm respectively; and the ones of butt-joint implants were (-1.77 ± 0.54) mm and (-1.82 ± 0.61) mm. The average PES of platform- switched implants after 1 year and 2 year were 10.43 ± 1.37 and 10.32 ± 1.21 respectively; the ones of butt-joint implants were 9.21 ± 0.97 and 9.16 ± 0.95. There were significantly differences of marginal bone changes and PES between both groups (P < 0.05). Conclusion Platform switching implant in the maxillary aesthetics area is more effective in preserving the surrounding bone tissue and aesthetic effect.
Objective To evaluate the effect of decompression treated large cystic lesions of the jawsand analyze the influencing factors. Methods With the panoramic radiographs, the cysts size were measured before and after decompression in 6 dentigerous cysts (DC), 9 keratocystic odontogenic tumors (KTOC) and 10 unicystic ameloblastomas (UA). The reduction rate in the three cystic groups was calculated. Relationships between the age of the patient, the initial size of the cyst and the reduction rate were also analyzed. Results The reduction size of the three types of cysts at 6 months after decompression: DC group 60.73% ± 7.15%, KTOC group 60.99% ± 4.00%, UA group 59.25% ± 6.81%.There was no difference in their reduction rate between the three types of cysts (P>0.05). However, there was a statistically meaningful relationship between the initial size of the lesion and the absolute reduction rate in the UA and KOTC group (UA group: P<0.01, R=0.99; KTOC group: P<0.01, R=0.86). There was also a significant relationship between the age of the patient and the absolute reduction rate in the DC and UA groups (DC group: P<0.01, R=0.99; UA group: P<0.01, R=0.99). Conclusion There was no difference in the reduction in size due to decompression between the three types of cysts. However, the age of the patient and the initial size of the lesion showed a significant relationship with the reduction rate.
Objective To discuss the changes of serum lipoprotein phospholipase A2 (Lp - PLA2) and c-reactive protein (CRP) levels in atorvastat in treatment for the patients with periodontitis and hyperlipidemia. Methods 148 patients with periodontitis and hyperlipidemia were involved, and divided into basic group (foundation treatment, 82 cases) and statin group (foundation treatment plus 20 mg atorvastatin treatment, 66 cases). 40 healthy cases from the medical center health personnel were selected as the healthy group. Attachment levels (AL), bleeding index (BI), serum total cholesterol (TC), triacylglycerol (TG), Lp - PLA2, and CRP levels were checked and compared before and after 6 months of treatment. Lp - PLA2 and CRP were checked by enzyme linked immunosorbent assay (ELISA), and their relationship were analyzed by the method of Pearson. Results When the disease group were compared with the healthy group, the statistics were as follows: AL（3.92 ± 0.51 mm vs 0.42 ± 0.06 mm）, BI（2.81 ± 0.48 vs 0.34 ± 0.05）, TC（5.27 ± 0.83 mmol/L vs 4.02 ± 0.62 mmol/L）, TG（2.67 ± 0.41 mmol/L vs 0.93 ± 0.17 mmol/L）, Lp-PLA2（243.57 ± 58.71 μg/L vs 132.24 ± 34.27 μg/L）, CRP（9.72 ± 3.27 μg/L vs 3.21 ± 0.87 μg/L）, and the statistics of disease group were significantly higher than the healthy group with a significant difference (P< 0.05). When Statin group was compared with basis group, the statistics were as follows: AL（3.70 ± 0.10 mmvs 3.78 ± 0.11 mm）, BI（1.05 ± 0.28 vs 1.43 ± 0.32）, TC（3.82 ± 0.67 mmol/L vs 4.51 ± 0.71 mmol/L）, TG（1.30 ± 0.29 mmol/L vs 1.83 ± 0.34 mmol/L）, Lp-PLA2（157.43 ± 40.18 μg/L vs 199.43 ± 47.24 μg/L）, CRP（4.21 ± 3.02 μg/L vs 6.37 ± 3.28 μg/L）, and the statistics of statin group were lower than that in basis group with a significant difference (P< 0.05). Pearson analysis showed Lp-PLA2 and CRP levels were positively correlated (r = 0.672, P< 0.05). Conclusion It shows the changes of Lp- PLA2 and CRP level were related with the clinical conditions of periodontitis combined with hyperlipidemia, and atorvastatin therapy can effectively reduce the body's blood lipid levels, and improve the treatment effects of periodontitis combined with hyperlipidemia.
Objective To investigate whether the RW-splint could be used to guide or determine the CR position of the lower jaw so as to provide help for the later diagnostic design. Methods 20 class ⅡⅠ malocclusion patients were recruited in orthodontic department of Foshan Stomatological Hospital. They were treated by RW-splint for half a year before orthodontic treatment. The overjet of anterior teeth were recorded before and after treatment. Results The overjet of anterior teeth was (6.792 ± 0.795) mm before treatment and (7.720 ± 0.930) mm after half a year's treatment. The overjet of anterior teeth had significant difference (t=6.319, P <0.01). The overjet change of anterior teeth between before treatment and half year after treatment was (0.928 ± 0.657) mm. Conclusion The RW-splint wearing before treatment can be used to guide or determine the mandible in the CR position.
Objective To investigate the effects of the first molar on the eruption of the third molar by comparing the changes of the third molar position after orthodontic treatment in different tooth extraction modes. Methods 39 cases of adolescent patients were selected and divided into three groups:the first molar extraction, first premolar extraction and non-extraction.The pretreatment, posttreatment panoramic radiographs were measured to analyze the change of the third molar position among these groups. Results There were significant differences (P< 0.05) in the average annual variation of the third molar eruption space and angle. The changes in first molar extraction group were larger than that in premolar extraction group and non-extraction group. The average annual variation of the third molar eruption space, three groups were (2.38 ± 1.62) mm, (1.61 ± 0.90) mm and (1.08 ± 1.49) mm; the average annual variation of eruption angle, the three were 1.89° ± 1.93°, 1.37° ± 1.16° and 0.83° ± 1.74°. Conclusion Compared with conventional treatment, mandibular first molar extraction can significantly increase the third molar eruption space and improve its eruption angle, which is beneficial to the eruption of the third molar.
Objective To investigate the relationship between the morphology of the oropharyngeal airway and the maxillofacial skeletal morphology by comparing the three-dimensional morphology of the oropharyngeal airway in different sagittal features of the high angle adult. Methods 60 high angle adults aged 18 to 36 years were divided into 3 groups based on their ANB angles, there were 20 adults in each group, the number of males were equal to females. The In vivo Dental 5.1 software for reconstructing the CBCT image of each one was used, the middle sagittal plane and axial plane in coronal, sagittal and axis view was adjusted, then the distances, volumes and minimum cross-sectional areas were measured. The differences among 3 groups and between different gender were compared. Results There was statistical difference in W-ETP among 3 groups (P< 0.05). There were statistical difference in H-GP、H-Total、W-PNSP、W-ETP、V-GP、V-Total (P< 0.05) between males and females, and these measurements of males were bigger than of females. Conclusion The difference of the size and shape of the oropharyngeal airway of high angle adults among different sagittal skeletal patterns was mainly reflected in the lowest width of glossopharyngeal airway, the oropharyngeal airway of males was bigger and longer than females.
Objective To explore the clinical application of cone beam CT in the diagnosis of traumatic anterior teeth before orthodontic treatment in order to reduce the risk of orthodontic treatment failure due to adhesion. Methods 48 fixed orthodontic treatment cases with the history of anterior teeth trama were selected. The anterior teeth were examined by CBCT to exclude root and alveolar bone adhesions. Results 3 cases of root-alveolar bone adhesion were found, and the upper anterioa teeth of the remaining 45 cases were successfully moved by orthodontic treatment. Conclusion CBCT examination is recommended to check the periodontal ligament in patients of fixed orthodontic treatment with the history of anterior teeth trauma in order to exclude the root-alveolar bone adhesion cases.
Objective To investigate the effect of different root canal obturation techniques on apical sealing in oval root canals. Methods 120 recently extracted human premolars with single oval canal were randomly divided into 6 groups, including single point obturation, warm gutta percha vertical condensation, cold lateral condensation obturation method combined with different root canal sealers (iRoot SP or AH-Plus). There're six groups in total, including single point iRoot group, warm gutta percha iRoot group, cold gutta percha iRoot group, single point AH group, warm gutta percha AH group, cold gutta percha AH group. Results Root depth of dye penetration in warm gutta percha iRoot group and warm gutta percha AH group were significantly lower than group single point iRoot group and single point AH group (P < 0.05), and root depth of dye penetration of warm gutta percha iRoot group, cold gutta percha iRoot group was less than warm gutta percha AH group, cold gutta percha group (P < 0.05), but there was no statistic difference between other groups (P > 0.05). Conclusion In root canal treatment, warm gutta-percha condensation technology can make the oval canal root achieve better sealing effect, using iRoot SP is better than using AH-Plus.
Osseointegration plays an important role in the functions and aesthetics of dental implant. This paper focus on the hormones closely related to the bone metabolism, including glucocorticoid, parathyroid hormone, calcitonin, melatonin, and oestrogen, and reviews the influence of hormones on the osseointegration.
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