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Table of Content

    20 September 2018, Volume 26 Issue 9
    Expert Forum
    Therapeutic progress of diabetic periodontitis
    Yi DING,Qi WANG
    2018, 26(9):  545-550.  DOI: 10.12016/j.issn.2096-1456.2018.09.001
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    In China, the prevalence of diabetes is increasing each year. Diabetic periodontitis, as a major complication of diabetes, retains a strong bidirectional correlation with diabetes. Periodontitis increases the risk of diabetes, and hyperglycemia aggravates periodontal inflammation. In recent years, efficient treatments for diabetic periodontitis have been increasingly emphasized, and the prevention and control of diabetic periodontitis remain difficult. It is very challenging to find the best way to recognize risk factors and increase the diagnosis rate. Deeply understanding the local and systematic biological features of diabetic periodontitis could lead to the development of clinical preventive and therapeutic strategies. This article reviews the clinical and biological characteristics of diabetic periodontitis and its treatment progress from a systemic and local perspective, with the aim of extending the work on the prevention and treatment strategies for diabetic periodontitis.

    Rational use of first-aid medicine in dental clinic
    Xiaojuan WANG,Bin FENG
    2018, 26(9):  551-556.  DOI: 10.12016/j.issn.2096-1456.2018.09.002
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    First-aid medicine is indispensable in emergency treatments, and the rational use of first-aid medicine is directly related to efficacy. Oral treatment seems to be simple, but there are still many potential risks with different levels. Therefore, the rational use of first-aid medicine is related to the patient’s life. First-aid drugs that are commonly used in oral practice include anti-shock vasoactive drugs, anti-heart failure drugs, anti-arrhythmia drugs, anti-angina drugs, glucocorticoids, anti-allergy drugs, electrolytes and acid-base balance regulators. This article summarizes the indications, usages, common adverse reactions and cautions of emergency medicine in the oral clinic. Additionally, the rational usage of first-aid medicine in the dental clinic is discussed. This work is expected to provide some suggestions for the reasonable use of emergency medicine in domestic dental clinics.

    Basic Study
    Antibacterial activity of the nisin-containing single-bond universal adhesive
    Yi TAN,Sui MAI,Jia LIU,Lisha GU
    2018, 26(9):  557-563.  DOI: 10.12016/j.issn.2096-1456.2018.09.003
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    Objective To investigate the antibacterial activity to Streptococcus mutans of a nisin-containing single-bond universal adhesive. Methods Nisin was mixed into the bonding agent to produce concentrations ranging from 0.01 g/mL to 0.05 g/mL for the experiments, and adhesive without nisin was used as the control. Dentin-resin specimens were prepared for the microtensile strength test to evaluate changes in the bonding strength. The proper concentrations were selected for more tests. ① An agar diffusion test was applied with filter paper to detect the release of nisin, and adhesive without nisin was used as the negative control, 0.01 g/mL Nisin aqueous solution was used as the positive control. ② Solidification; resin adhesive specimens were prepared for the assessment of direct contact inhibition activity. ③ Confocal laser scanning microscopy was used to examine the effect of the adhesive on the biological film activity and the ability of Streptococcus mutans to produce extracellular polysaccharides. Results Nisin did not significantly reduce the bond strength of the modified adhesive at 0.01-0.03 g/mL (P < 0.05); these concentrations were selected for the subsequent antibiosis experiment. Rings could not be observed in the agar diffusion test, except for in the group of adhesive modified with 0.01-0.03 g/mL nisin. Resin adhesive with 0.01-0.03 g/mL nisin could significantly inhibit the proliferation of Streptococcus mutans on the surface of the specimens. The confocal laser scanning microscopy results indicate that only the adhesive resin modified with nisin could reduce the bacteria in the biofilm and the production of extracellular polysaccharides. Conclusion Single-bond universal adhesive with 0.01-0.03 g/mL nisin can inhibit the growth of Streptococcus mutans and its biofilms on the bonding interface, as well as decrease the production of extracellular polysaccharides, and thus has the potential to decrease the occurrence of secondary caries.

    Effect of cold light whitening technique combined with infiltration resin in the treatment of dental fluorosis
    Bingjie ZHANG,Danni WU,Bohua SU
    2018, 26(9):  564-568.  DOI: 10.12016/j.issn.2096-1456.2018.09.004
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    Objective To observe the effect of infiltration resin combined with cold light whitening in the treatment of dental fluorosis. Methods According to the distance between teeth and the long axis of each tooth, 18 anterior teeth were divided equally and randomly between group A and B. Samples in group A underwent cold light whitening, while samples in group B were treated with infiltration resin combined with cold light whitening. The color was measured before and after the treatment. Then, 6 teeth (the first subgroup) were randomly selected from the 18 anterior teeth after measurement for scanning electron microscopy (SEM) to observe the surface microstructure of the teeth. Then, another 6 teeth (the second subgroup) were selected from the remaining 12 teeth for the measurement of the color level and ΔE after being dyed with tea. Results After treatment, the color level changed significantly in group A and B (P < 0.05), ΔE in group A and B was 13.75, 14.98. There was no significant difference in the color level change between group B and group A, there was a significant difference in the ΔE between the two groups (t = -3.58, P < 0.05). SEM showed that the enamel surface was intact and that the enamel space was filled in group B. In group A, the enamel surface was reduced and uneven, and the characteristic badminton racquet shape of the enamel was not obvious. The color level was lower in both groups after staining, and these differences were significant (P < 0.05), ΔE in group A and B was 19.69, 18.95. There was no significant difference in the color level (t = 1.00, P > 0.05) and ΔE (t = 0.02, P > 0.05) between two groups. Conclusion Cold light whitening combined with infiltration resin is better for treating dental fluorosis than cold light whitening alone.

    Cinical Study
    Indication selection and efficacy analysis of condylar fracture
    Jia LI,Zhaochen SHAN,Yanmin SONG,Yaju WANG,Wenzhang GE,Wei TANG
    2018, 26(9):  569-573.  DOI: 10.12016/j.issn.2096-1456.2018.09.005
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    Objective The present study examined the effects of surgical and conservative treatment on the curative effect of patients with condylar fracture to determine the best treatment scheme and indication. Methods A total of 339 clinical cases of condylar fracture were selected, and pain severity, degree of mouth opening, angle of condylar fracture (calculated as the difference in the angle of the condylar between the fractured side and uninjured side) and the height of the mandibular ramus (calculated as the difference in the height of the mandibular ramus between the fractured side and uninjured side) of patients at admission were measured and analyzed. The effects of surgical treatment (rigid internal fixation) and conservative treatment (functional therapy) were evaluated and compared 6 months after treatment. Results Among the patients with a condylar fracture displacement angle ≥ 11.50°, Significantly more (χ 2= 26.38, P < 0.05) patients exhibited good recovery 6 months after surgical treatment [69.4% (118/170)] than those after conservative treatment [35.4% (29/82)]. Among the patients with a condylar fracture displacement angle < 11.50°, there was not a significant difference (χ 2= 0.55, P > 0.05) between the numbers of patients who exhibited good recovery 6 months after surgical treatment [52.4% (22/42)] and conservative treatment [44.4% (20/45)]. Among the patients with mandibular ramus height ≥ 4.19 mm, significantly more (χ 2= 20.35, P < 0.05) patients exhibited good recovery 6 months after surgical treatment [64.7% (112/173)] compared with those after conservative treatment [35.6% (32/90)]. Among the patients with mandibular ramus height < 4.19 mm, there was not a significant difference (χ 2= 0.21, P > 0.05) between the numbers of patients who exhibited good recovery 6 months after surgical treatment [46.7% (14/30)] and conservative treatment [41.3% (19/46)]. Conclusion Patients with a displacement angle of condyle fracture greater than 11.50° and a mandibular ramus height less than 4.19 mm exhibit the greatest pain and a better effect from surgical treatment than those from conservative treatment.

    Study of the Er: YAG laser in periodontal flap surgery for the treatment of chronic periodontitis
    Zhenzhe LIU,Liang ZHAO,Huairong HUANG,Wenxia HUANG,Hongbai CHEN
    2018, 26(9):  574-577.  DOI: 10.12016/j.issn.2096-1456.2018.09.006
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    Objective Objective To explore the role of the Er: YAG laser in periodontal surgery. Methods Twenty patients with chronic periodontitis in two quadrants were selected for this study. One quadrant was subjected to pure periodontal flap surgery, whereas the other was subjected to flap surgery with an adjunctive Er: YAG laser. The preoperative and 3- and 6-month postoperative clinical parameters, including the probing depth, clinical attachment level, gingival recession, plaque index, gingival index and tooth mobility, were recorded. Results Significant differences were not observed between the open flap surgery + Er: YAG laser-assisted treatment group and the open flap surgery group except for the gingival index after 3 months (0.36 ± 0.26 vs. 0.58 ± 0.29, t=3.831, P < 0.001) and 6 months (0.60 ± 0.23 vs. 0.83 ± 0.22, t=4.013, P < 0.001). Conclusion Er:YAG as an auxiliary treatment for periodontal flaps, does not significantly reduce the depth of periodontal pockets, nor could it improve the clinical adhesion level and the gingival recession, but it can improve the recovery of gingival inflammation and accelerate the healing of tissue.

    Clinical observations of all-ceramic restorations of children’s first permanent molars with severe defects
    Xin ZENG,Yu SONG,Yanling YU,Changyu CAI,Jing LIN
    2018, 26(9):  578-583.  DOI: 10.12016/j.issn.2096-1456.2018.09.007
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    Objective To explore the therapeutic efficacy of chairside CEREC all-ceramic restorations in children with first permanent molars with severe defects and to summarize the clinical methods and procedures. Methods Forty teeth of 7-15 years old thirty-four children with first permanent molars with severe defects were selected. After careful tooth preparation, a total of 40 all-ceramic restorations (8 inlays, 32 onlays) were designed and manufactured using the CEREC 3D system, and all prostheses were bonded with composite resin cement. Immediately after treatment and after 24 months, the subjective satisfaction of the patients was assessed. The clinical efficacy was analyzed using modified USPHS criteria at 12 months and 24 months. Evaluations included secondary caries, marginal adaptation, surface texture, color matching, fracture, anatomical form, adjacency relationship and gingival health. Results For the 40 all-ceramic restorations of the first permanent molars, after 24 months, 100% of the teeth were grade A for secondary caries, surface texture and fracture of the prosthesis, and 85% of the teeth were up to grade A for the other indexes at 12 and 24 months. There were no significant differences (P > 0.05) between 12 months and 24 months. Immediately after treatment and after 24 months, the subjective satisfaction of the patients was greater than 94%. Conclusion Application of the CEREC 3D system had a clear curative effect and resulted in high satisfaction in the repair of permanent molars with severe defects in children.

    Osteogenic potential of recombinant human bone morphogenetic protein-2 combined with Bio-oss bone substitute in implant restorations in anterior esthetic region
    Xueqian LI,Qiao ZHANG,Xiaoxin ZHANG,Yufeng ZHANG
    2018, 26(9):  584-591.  DOI: 10.12016/j.issn.2096-1456.2018.09.008
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    Objective To study the osteogenic potential of recombinant human bone morphogenetic protein 2 (rhBMP-2) combined with Bio-oss bone substitute in the implant restoration of bone defects in the anterior esthetic region. Methods Twelve patients who underwent the immediate placement of 20 implants with a bone augmentation procedure using rhBMP-2 and Bio-oss were included in this study. Changes in the height and thickness of the buccal bone over 6 months were measured, and the soft tissue was evaluated using the pink esthetic score (PES) after crown placement. Results All 20 implants were successfully osseointegrated, and the average increase in bone height was 1.9 mm; different degrees of bone height growth were observed for 17 (85%) implants sites. In one case, there was a severe bone fracture on the buccal side before the operation, resulting in bone plate resorption and decreased alveolar bone height. The bone height did not change significantly in 2 cases. The thickness of the buccal bone plate for all implants was greater than 1 mm. The average thickness was 1.9 mm, and the average PES was 9.8 points. Conclusion rhBMP-2 combined with Bio-oss bone substitute has a preferable effect on the restoration of bone defects in the anterior esthetic area, and can achieve good aesthetic effect.

    Prevention and Treatment Practice
    Aggressive fibromatosis of the head and neck: case report and literature review
    Zhengqiang LI,Shuguang LIU
    2018, 26(9):  592-597.  DOI: 10.12016/j.issn.2096-1456.2018.09.009
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    Objective To evaluate the clinical manifestations, pathological features, treatment methods and prognosis of aggressive fibromatosis of the head and neck. Methods One patient with aggressive fibromatosis of the neck was analyzed, and the relevant literature was reviewed. Results Head and neck lesions account for approximately 12 to 15% of aggressive fibromatosis, which is a rare type of borderline tumor that is commonly characterized by a hard texture, painlessness (but occasionally with pain), hidden growth and poor mobility. Such tumors can result in facial deformity and invasion of the skull base or main nerves, and blood vessels and can compress the airway. MRI is the preferred method for preoperatively determining the size and location of the lesion. The characteristic low T1 and T2 signals of collagen fiber are helpful for the diagnosis of the tumor. The disease has clear pathological features, with tumors consisting of long spindle fibroblasts and myofibroblasts arranged in parallel fascicles with various levels of collagen formation. The tumor cells exhibit the characteristics of infiltrative growth, ill-defined cell membranes and variable amounts of cytoplasm. Pathologic mitosis and atypia are not seen. Characteristic immunohistochemical features include expression of Vim(+), HHF-35(+), CD34(-), S-100(-) and Ki-67(+). The disease is locally invasive, and patients may relapse easily, but distant metastases are not observed. The primary treatment is surgical resection. Chemotherapy, hormone therapy and biological treatments have auxiliary functions in the treatment of these tumors. Conclusion Aggressive fibromatosis of the head and neck has no specific clinical features; the diagnosis depends primarily on pathological examination. The main treatment is radical surgical resection. Radiotherapy, chemotherapy and biological treatment can be used in combination with surgery in cases of incomplete resection or recurrence.

    Study on the role of knowledge, attitude/belief, and practice (KAP) nursing mode in treating patients with fixed orthodontic appliances
    Yumeng ZHONG,Dong CHEN,Chang XIE,Zhiyun LU
    2018, 26(9):  598-600.  DOI: 10.12016/j.issn.2096-1456.2018.09.010
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    Objective To study and analyze the effect of applying the knowledge, attitude/belief, and practice (KAP) nursing mode in caring for patients who receive fixed orthodontic treatment. Methods A total of 112 patients who received orthodontic treatment were selected as study subjects. They were randomly divided into an observation group and a control group, with 56 patients in each group. Patients in the control group were treated with conventional oral care, while those in the observation group were treated with the KAP nursing mode. The patients’ awareness of the disease, treatment compliance, and orthodontic complications were compared between the two groups. Results After treatment with the KAP nursing mode, the disease cognition score was significantly higher in the observation group than in the control group (P < 0.05). Patient compliance was better in the observation group than in the control group throughout the treatment. Patients in the observation group were more able to return to the hospital on time than those in the control group. The orthodontic plaque index (OPI) of patients in the observation group decreased during the treatment. The OPI of patients in the observation group was significantly lower than that of patients in the control group at 6 months (t=2.344) and 12 months (t=3.721) after the start of the treatment (P < 0.05), and the incidence of orthodontic complications in the observation group was 7.1% (4/56), significantly lower than that in the control group (26.9% (15/56); χ 2=9.728, P < 0.05). Conclusion Application of the KAP nursing mode can effectively reduce the incidence of complications in patients with fixed orthodontics, improve the oral health of patients, and positively affect orthodontic treatment.

    Review Articles
    Relationship between T cells and bone regeneration: recent progress and perspectives
    Renli YANG,Yuanjing WANG,Shimin WEI,Wen HUANG,Yufei WANG,Chenyou ZHU,Yili QU
    2018, 26(9):  601-605.  DOI: 10.12016/j.issn.2096-1456.2018.09.011
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    Bone is capable of regeneration after injury, but the process of properly restoring form and function is highly complex and prone to failure. The restoration process requires highly ordered and sequential interplay at the injury site between the host immune system and bone tissue. The dynamic process that occurs after bone injury includes the formation of a hematoma, the development of an inflammatory response and callus, and the remodeling of newly formed bone tissue. The inflammatory response at the injury site is essential for the onset of bone regeneration. This inflammatory response is tightly linked with the host immune system, in which various immune cells and molecules are involved. Recently, the relationship between T cells and bone regeneration has become a popular topic; however, currently, there are no summaries of the relationship between T cells and bone regeneration. Thus, this review aimed to elucidate the modulatory functions of T cells in bone regeneration.

    Research status of the relationship between periodontitis and systemic disease
    Miaoying CHENG,Dan LIANG,Zhiqun TANG,Hongkun WU
    2018, 26(9):  606-612.  DOI: 10.12016/j.issn.2096-1456.2018.09.012
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    Periodontitis is a common infectious disease that is harmful to human oral health and is the main cause of tooth loss. Periodontal inflammation can damage the integrity of the epithelium, causing periodontal pathogens to spread to the systemic circulation, and the periodontal pocket contains a large number of inflammatory mediators, especially those related to chronic inflammation, such as tumor necrosis factor-α, interleukins and prostaglandins, which will enter the blood circulation system from periodontal pocket and cause systemic inflammatory response. Periodontitis is closely related to the occurrence and development of systemic diseases, including cardiovascular, endocrine, respiratory, immune, and nervous systems. Inflammatory responses and inflammatory factors may be the mechanism of the association between periodontitis and multiple systemic diseases. This article reviews the current research on the relationship between periodontitis and systemic disease.