Tooth defects due to dental caries, trauma, abrasion, etc., are extremely common and can be treated by direct or indirect restoration. Compared with resin directly filling the body, an inlay can better restore the occlusal contact relationship and the adjacent surface contact relationship and has good mechanical properties. In recent years, with the development of ceramic materials and bonding systems and the popularity of chairside CAD/CAM technology, the chairside CAD/CAM porcelain inlay restoration program has been well received by doctors and patients because of its accuracy, convenience, aesthetics, hardness and stability, and this program is widely used clinically. This review covers the research status of various aspects such as indications and contraindications for chairside CAD/CAM inlay restoration, pre-restoration preparation, tooth preparation, hole type, impression taking and design, porcelain block selection, bonding, polishing, postoperative doctor’s instructions, and common postoperative complications. It is expected to provide a reference for the clinical application of and research on chairside CAD/CAM inlay restoration technology.
Decompression is an effective and widely used treatment for jawbone cystic lesions that can, to a great extent, preserve the function and appearance of the jawbone. However, some problems exist with its clinical application, such as the inappropriate determination of indication and the lack of standardized operational guidelines, resulting in treatment ineffectiveness or even failure. This paper aimed to summarize the clinical value of decompression for jawbone cystic lesions in terms of mechanism, scientific evidence, advancement, indications and effective evaluation by reviewing relevant literature and our clinical experience.
Objective To investigate the morphological changes in microglia and astroglia before and after the removal of occlusal interferences in rats and to further understand whether astroglia and microglia activation is involved in experimental occlusal interference-induced masticatory muscle pain.Methods Male Sprague-Dawley rats (200-220 g) were used. Crowns of two heights (0.2 mm and 0.4 mm) were bonded to the right maxillary first molars to establish experimental rat models of occlusal interference. The rats were randomly assigned to one of five groups of twelve rats each: sham-occlusal interference control group, 0.4 mm occlusal interference group, 6-day removal of 0.4 mm occlusal interference group, 0.2 mm occlusal interference group, and 6-day removal of 0.2 mm occlusal interference group. The rats were sacrificed by transcardiac perfusion after deep anesthetization on days 3, 5, 7, and 14. Brain stem sections were obtained and processed for immunofluorescence staining of GFAP and OX-42. Expression levels were semiquantitatively analyzed.Results ① Based on the markers OX-42 and GFAP, trigeminal-spinal nucleus (Vsp) microglia and astroglia showed no activation in the sham-occlusal interference control group. ② In the 0.4 mm and 0.2 mm occlusal interference groups, Vsp microglia and astroglia showed mild to moderate activation after 3-7 days of occlusal interference. Vsp astroglia remained activated on day 14, but Vsp microglia did not. At the same time point, the 0.4 mm occlusal interference group had greater activation than the 0.2 mm occlusal interference group. ③ In the 6-day removal of 0.4 mm and 0.2 mm occlusal interference groups, microglia and astroglia activation decreased after removal of the occlusal interference. Vsp astroglia remained activated on day 14, but microglia showed no activation.Conclusion Microglia and astrocyte activation is induced in the Vsp after experimental occlusal interference. The astrocytes remained activated for longer than the microglia. The glia activation level is closely related to the intensity of occlusal interference.
Objective To observe the killing and clearance effect of an Er:YAG laser combined with sodium hypochlorite on Enterococcus faecalis at different depths of the root canal in vitro to provide a reference for clinical application.Methods A total of 75 models of Enterococcus faecalis infection were successfully established and randomly divided into three groups (25 per group). Ten random samples per group underwent no processing. The remaining models in group A were treated with an Er:YAG laser combined with sodium hypochlorite 52.5 g/L. Group B was treated with 52.5 g/L sodium hypochlorite (positive control), and group C was treated with normal saline (negative control). The bacterial reduction rate was calculated for each group. The bactericidal effect on the surface of the root canal wall was observed in 5 samples by scanning electron microscopy.Results There was no statistically significant difference (P > 0.05) between group A (100.00 ± 0.00) and group B (98.62 ± 2.01) but was a statistically significant difference between group A (100.00 ± 0.00) and group C (64.37 ± 2.45) (P < 0.05). The percentage reduction in bacteria was higher in group A (99.46 ± 2.31) than in groups B (92.89 ± 3.07) and C (56.72 ± 4.96) (P < 0.05). The decrease in bacteria was greater in group A (97.62 ± 3.73) than in groups B (72.49 ± 2.35) and C (44.42 ± 4.78) (P < 0.05). The bacterial reduction rate in group A (95.89 ± 2.46) was higher than that in groups B (63.88 ± 1.08) and C (33.31 ± 5.21) (P < 0.05). There were significant differences at different dentin depths in the bacterial reduction rates among groups A, B and C (P < 0.05). Electron microscopy analysis showed that the Er:YAG laser combined with 52.5 g/L sodium hypochlorite was better than either treatment alone at removing bacteria from the surface of the root canal wall.Conclusion An Er:YAG laser can effectively enhance the bactericidal effect of sodium hypochlorite on the inner wall of the root canal.
Objective To provide a clinical reference by evaluating the restorative results of an accurate impression technique for distal-extension removable partial dentures.Methods Forty-two patients with free-end dentition defects who visited the Prosthodontic Department of Nanjing Stomatological Hospital, Medical School of Nanjing University, between April 2017 and January 2018 were selected. The final impression was made by an accurate impression technique to fabricate fifty-two removable partial dentures with casting frameworks. The restorative result was judged by clinical examination and patient feedback immediately after wearing dentures and at 1 week, 3 months and 6 months.Results All fifty-two dentures for forty-two patients were seated successfully, with good retention and stability. Complications occurred throughout the 6-month follow-up, including 4 cases of mucous pain, 4 cases of retention force attenuation and 1 case of abutment fracture. There were no periodontics problems. The dentures garnered high patient satisfaction.Conclusion The accurate impression technique for distal-extension removable partial dentures showed good clinical results in this follow-up investigation.
ObjectiveTo understand the level and current status of oral health knowledge among people aged 35-44 years in Guangdong Province and to provide a reference for oral health education in Guangdong Province. MethodsAn equal-sized, stratified, multistage, random sampling design was applied to obtain representative sample groups consisting of 288 Guangdong residents aged 35-44 years in four urban areas and four rural areas with a gender ratio of one to one. According to the Guideline of the 4th National Oral Health Survey, a questionnaire survey was conducted, and a statistical analysis of the questionnaire responses related to oral health knowledge was performed. ResultsIn total, 288 people participated in the survey, of which 95.8 percent were aware that “Oral health is very important to their own lives, and the prevention of oral diseases depends on themselves first”, 76.0% recognized that “Regular oral examination is very necessary”, and 66.7% disagreed that “Teeth were innate and had little to do with their own protection”. The percentages of participants that agreed with the statements “Eating sugar can cause dental caries”, “Oral disease may affect general health”, “Bacteria may cause dental caries” and “Bacteria may cause gum inflammation” were 87.2%, 84.7%, 80.9%, and 80.2%, respectively. However, the rates of awareness that teeth could be protected by fluoride and by pit and fissure sealant were only 36.8% and 18.8%, respectively. ConclusionGeneral knowledge of oral health care was relatively high among adults aged 35-44 years in Guangdong Province, but knowledge of fluoride, pit and fissure sealing and caries prevention was relatively low. Oral health education should be continuously improved, especially regarding the popularization of oral health knowledge.
Objective To explore the application effect of secondary personalized chairside education on changing the knowledge and behavior of patients with oral periodontal disease. Methods A total of 124 patients experiencing initial periodontal disease were selected. Sixty-two patients were observed in the observation group, and 62 patients were observed in the control group. After the doctor checked and determined the periodontal condition of the patients, the nurse conducted a targeted, personalized secondary one-on-one chairside mission for the observation group; in the control group, the nurses provided routine one-to-one health education to the patients before treatment. Statistical analysis was conducted to assess periodontal knowledge mastery, self-care behaviors, rate of return for periodontal treatment and patient satisfaction after 3 months. The plaque index and scale index were statistically analyzed before and 3 months after treatment. Results No statistical difference was found in the general data between the two groups of patients (P > 0.05); however, the degree of mastery of periodontal knowledge in the observation group was higher than that in the control group. The degrees of mastery of the clinical manifestations, hazards and treatment methods were 96.7%, 93.5%, and 91.9% in the observation group and 72.5%, 48.3%, and 69.3% in the control group, respectively; the difference was statistically significant (P < 0.05). The patients in the observation group were more likely than those in the control group to brush more than 2 times daily, use dental floss and use an interdental brush; 100%, 96.7%, and 77.4% of patients in the observation group and 80.6%, 56.4%, and 40.3% of patients in the control group participated in these oral health care behaviors, respectively. The difference was statistically significant (P < 0.05). The rate of recovery and patient satisfaction were higher in the observation group than in control group at 3 months; the rate of recovery and patient satisfaction were 80.6% and 96%, in the observation group and 41.9% and 88.7% in the control group, respectively. The difference was statistically significant (P < 0.05). After 3 months, the plaque index in the observation group was lower than that in the control group (1.71 ± 1.12, 2.35 ± 0.78), and the difference was statistically significant (P < 0.05). Conclusion Secondary personalized chairside education can significantly improve the patient’s cognition of the disease, allow the formation of accurate oral health awareness, and change the patient’s bad oral hygiene habits and medical behavior. Thus, this method is an effective oral health education method and can change the knowledge and beliefs of patients with oral periodontitis.
The treatment of oral cancer patients mainly involves surgery in combination with radiotherapy and chemotherapy. This paper reviews the clinical features of perioperative patients with oral cancer, including oral flora imbalance, oral complications after radiotherapy and chemotherapy, the presence of oral incisions (and flaps), special dietary needs, and airway management. In connection with the above characteristics, this article analyzes the necessity of three aspects of oral care to improve the patient’s comfort and prevent pulmonary and surgical site infections, with the goal of providing a reference for oral care research on patients undergoing oral cancer surgery and laying a foundation for the construction of comprehensive oral care programs during the perioperative period for patients with oral cancer.
The morphology of the gingival papilla plays an important role in the aesthetics of oral soft tissue. Gingival papilla recession forms a visible black triangle, causing a series of problems such as aesthetic defects, pronunciation disorders and food impaction and even endangering the health of periodontal tissue. Gingival papilla reconstruction is an effective way to eliminate the black triangle. However, the treatment of lost or collapsed gingival papilla is unsuccessful. Reconstruction of the interdental papilla for aesthetics zone is the most difficult and challenging periodontal treatment. In this article, we review the past literature and summarize the factors affecting the appearance of gingival papilla, including the distance between the contact point and the alveolar crest, the distance between roots, divergent roots, interdental width, embrasure morphology, crown shape, and gingival biotype. The classification of the gingival papilla based on the loss of papillary height and the nonsurgical and surgical methods for the reconstruction of gingival papilla are reviewed to provide a reference for doctors to reconstruct the gingival papilla.
The pathogenesis of burning mouth syndrome (BMS) is not clear. Most scholars believe that primary BMS is a chronic neurological disease. Advanced diagnostic methods such as quantitative sensory testing (QST), trigeminal neuron electrophysiological recording and peripheral nerve blockade, structural analysis of epidermal nerve fiber density (ENFD), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) classify neuropathic pain in most BMS patients as peripheral or central. Hormone replacement, dopaminergic drugs and noninvasive neuromodulation may be new approaches to BMS based on its pathogenesis. This article reviews the clinical features, pathophysiological mechanism, new diagnostic methods and treatment of primary BMS and provides new ideas for the clinical diagnosis and treatment of BMS.
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