Sj?gren′s syndrome lacks a single and objective diagnostic index, and its diagnosis often requires comprehensive analysis according to classification criteria. With increasing research and a deepening understanding of the disease, the classification criteria are constantly being adjusted and revised. The sensitivity and specificity of the diagnosis have gradually improved, which has the value of diagnostic criteria largely. Since 1965, more than ten diagnostic criterias for Sj?gren′s syndrome have been published. After debate and experience, international criteria with wide applicability have gradually replaced regional criteria. In the evolution of the diagnostic criteria, the diagnostic rules and evaluation methods have become more concise and unified. Techniques with poor specificity and operative difficulty, which are not easy to popularize or apply in the clinic, have gradually been eliminated. A diagnostic system based on an objective examination and subjective symptoms has gradually formed, and lip gland biopsy and serum autoantibody sampling have demonstrated great diagnostic value. The optimization of diagnostic rules makes the diagnosis of this disease more efficient and scientific. This paper reviews the characteristics of and differences in diagnostic criteria for Sj?gren′s syndrome and analyzes the internal logic of the evolution of different diagnostic criteria in light of development in research on the disease with the hope of benefitting the diagnosis, treatment and related research of Sj?gren′s syndrome.
Microbial infections affect people worldwide. Quaternary ammonium salts serve antibacterial, antifungal, antiviral, anti-matrix metalloproteinase and polymerization functions. While the modification of biomaterials with quaternary ammonium salts cannot affect the physical or chemical properties of the biomaterials, this process can confer them with stable biological activity. Currently, quaternary ammonium salts are widely used in the development of functional orthopedic materials, sutures, dressings and dental materials, and the idea of modifying biomedical materials with quaternary ammonium salts has become the most promising, e.g., for preparing antimicrobial biomaterials. Recent studies have found that quaternary ammonium salt-modified antimicrobial monomers are cytotoxic. Therefore, it is of great significance to explore the cytotoxic mechanism of quaternary ammonium salt-modified antimicrobial monomers and determine possible cytoprotective measures for improving the biological safety of these antimicrobial resin-based materials and expanding their clinical applications. In addition, further validation of the clinical efficacy of these biomaterials is particularly important for accurately evaluating the clinical prospects of these biomaterials. Based on a literature review, this paper summarizes the applications and toxicity of biomedical materials modified with quaternary ammonium salts.
Objective To explore the effect of hypoxia inducible factor 1α (HIF-1α) gene silencing in rat bone marrow mesenchymal stem cells (BMMSCs) under mechanical distraction on the expression of bone sialoprotein (BSP) and osterix and to provide a new idea for repairing bone defects with BMMSCs.Methods The shRNA sequence was designed according to the rat HIF-1α gene, and the pGMLV-SC1RNAi lentiviral vector was cloned after PCR amplification. After screening positive clones and identifying competent transformed cells by sequencing, 293T cells were packaged and titered, rat BMMSCs were transfected and cultured in vitro. Clones with stably silenced HIF-1α expression were screened by inverted fluorescence microscopy. The RNAi response experiment was divided into four groups: the blank control group, the HIF-1α shRNA group, the negative control group, and the response group. Western blot was used to detect the expression of HIF-1α protein in the four groups to verify the response of the target genes and exclude off-target effects. A Flexcell FX-5000T cell stress loading system was used to intervene in the mechanical stretch of the cells. qRT-PCR and Western blot were used to detect the expression of BSP and osterix in the blank control group, HIF-1α shRNA group, and negative control group.Results The HIF-1α shRNA lentiviral vector was successfully constructed. The results of the RNAi response showed no significant difference in the expression of HIF-1α between the response and the blank control group (P > 0.05). The recombinant lentivirus could effectively silence HIF-1α in BMMSCs. After mechanical distraction of the BMMSCs, compared with the blank and negative control groups, the HIF-1α shRNA group showed significantly increased mRNA and protein expression of the bone-related factors BSP and osterix (P < 0.05); there was no significant difference in the mRNA and protein expression of BSP or osterix between the blank and negative control groups (P > 0.05).Conclusion Silencing HIF-1α in BMMSCs under mechanical distraction can promote the expression of BSP and osterix.
Objective To investigate the effect of Kamistad gel on oral ulcer healing and the expression of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6) and epidermal growth factor (EGF) after oral administration in ulcer tissue of rats and to provide animal experimental data for the clinical application of Kamistad gel.Methods The oral ulcer rat model was established by chemical cauterization. The rats were randomly divided into four groups: Kamistad group (Kamistad gel), befuxin group (befuxin gel), lidocaine group (lidocaine cream), blank control group (normal saline), with 12 rats in each group. The ulcer area of the rats in each group was measured before and 1, 3 and 5 days after treatment; at 1 day after treatment, the duration of swabbing behavior within 3 minutes of intraoral capsaicin infusion was recorded to evaluate the degree of pain; the ulcer tissue was collected at 5 days after treatment, and the histopathological changes were observed by HE staining, the expression of TNF-α, IL-6 and EGF in the ulcer tissue was detected by immunohistochemistry and ELISA.Results At 1 day after treatment, the duration of mouth wiping induced by capsaicin was significantly shorter in the Kamistad group than in the blank control and befuxin groups (P < 0.05), but there was no significant difference between the Kamistad and lidocaine groups (P >0.05). At 5 days after treatment, the ulcer area was significantly smaller in the Kamistad group than in the blank control and lidocaine groups (P < 0.05), and there was no significant difference between the Kamistad and befuxin groups (P >0.05). At 5 days after treatment, H&E staining of the oral ulcer tissue sections showed significantly reduced levels of inflammatory cells and significantly proliferated fibroblasts and better epithelial hyperplasia in the Kamistad group compared with those in the lidocaine and blank control groups, and there were no differences between the Kamistad and befuxin groups. At 5 days after treatment, the expression levels of TNF-α, IL-6 and EGF in the ulcer tissue of rats in each group were significantly different (P < 0.05). Compared with the blank control and lidocaine groups, the expression of TNF-α and IL-6 was significantly decreased and the expression of EGF was significantly increased in the Kamistad group (P < 0.05); there were no significant differences in the expression of the above three factors between the Kamistad and befuxin groups (P > 0.05).Conclusion Kamistad gel exhibited anti-inflammatory, analgesic and healing effects on experimental oral ulcers.
Objective To observe the expression of interleukin-33 (IL-33) in macrophages of chronic periapical periodontitis and apical cyst tissue, and to provide a basis for the study of the pathogenesis of IL-33 in periapical diseases. Methods The apical tissues of 20 normal control group, 15 chronic periapical periodontitis group and 15 apical cyst group were collected for HE staining and optical microscopy respectively. CD14 was used as the marker of macrophages and double immunofluorescence staining was used to observe the changes of periapical tissues under fluorescence microscopy. The expression of IL-33 in CD14-positive macrophages was observed.Results The macrophage density (cell/mm 2) of IL-33 and CD14 positive expression in normal control group, chronic periapical periodontitis group and root cyst group were（23.81 ± 5.16,62.97 ± 8.54,119.83 ± 14.61) respectively, and there were significant differences among the three groups（F=87.17,P < 0.01）. The density of IL-33 and CD14 positive macrophages in root cyst group was significantly higher than that in chronic periapical periodontitis group and control group（P < 0.01）.Conclusion IL-33 and CD14 positive macrophages increased in normal apical tissue, chronic periapical periodontitis tissue and apical cyst tissue in turn.
Objective To study the sedative efficacy and safety of nitrous oxide (N2O ) inhalation combined with oral midazolam in children with impacted supernumerary teeth for extraction under sedation and to provide a reference for the selection of anesthetic methods for children undergoing impacted teeth extraction.Methods Sixty patients aged 5-10 years with maxillary impacted supernumerary teeth were randomly divided into three groups, with 20 in each group, as follows: the N2O group: N2O inhalation sedation before the operation; the midazolam group: oral midazolam sedation before the operation; the combination group: N2O inhalation combined with oral midazolam sedation before the operation. Sedation was performed before extraction under local anesthesia. The Ramsay sedation effect, Houpt behavioral score and incidence of adverse reactions were evaluated after the operation. Results The Ramsay sedation scale score was significantly higher in the combination group (2.75 ± 0.55) than in the N2O group (2.30 ± 0.47) and the midazolam group (2.40 ± 0.50) (P ＜0.05). Similarly, the Houpt behavioral rating scale score was significantly higher in the combination group (5.25 ± 0.64) than in the N2O group (4.70 ± 0.73) and the midazolam group (4.80 ± 0.69) (P ＜0.05). The adverse reaction rate was lower in the combination group (5%) than in the N2O group (10%) and the midazolam group (10%), but the difference was not significant (χ2=0.436, p=0.804). Conclusion N2O inhalation combined with oral midazolam sedation in the extraction of impacted supernumerary teeth in children can significantly improve the sedative and therapeutic efficacy and is a safe and effective sedation method.
Objective To explore the clinical epidemiological characteristics and treatment methods of maxillofacial fracture patients in the Kashgar Prefecture to provide a reference for clinical diagnosis and treatment.Methods The medical records of 1 115 patients with maxillofacial fracture admitted to the First People's Hospital of Kashgar from November 2011 to November 2016 were retrospectively analyzed by age composition, sex ratio, cause of trauma, time of injury, site of injury and systemic complications.Results Among the 1 115 patients, the ratio of males to females was 4.7∶1, and those aged 21 to 30 years accounted for the majority of patients, with most injuries occurring in the summer (31.38%) and spring (29.69%). The most common cause of trauma was falling (38.57%), followed by traffic accidents (36.95%). Midfacial fractures were the most frequently observed (65.38%), followed by mandibular fractures(30.26%). In all, 42.15% of cases were complicated with systemic injuries, the majority being ocular injuries (35.55%), followed by limb injuries (21.67%). The majority of patients (50.04%) chose treatment by open reduction and internal fixation. Logistic regression analysis showed that males were more prone to midfacial fractures than females. The occurrence of midfacial fracture became more likely with increasing age.Conclusion In the Kashgar Prefecture, the majority of patients with maxillofacial fracture are male and young or middle-aged. Most maxillofacial fractures occur in the spring or summer and are mainly caused by falling or traffic accidents. Fractures in the middle part of the face are more common. Ocular injury is the most common complication, and in most cases, the fracture is treated by open reduction and internal fixation. The occurrence of midfacial fracture is closely related to age, sex and cause of trauma.
Objective To explore the clinical effect of composite resin inlays in repairing large areas of primary molar defects after root canal treatment to provide a reference for the restoration of carious primary molars.Methods Thirty-eight primary molars of 32 children were selected as the research objects. Indirect restoration with composite resin inlays was performed after root canal therapy. The clinical efficacy was evaluated in terms of five indices, including restoration retention, marginal integrity, gingival status, anatomical morphology and secondary caries, according to the modified USHPS evaluation criteria, at 6, 12 and 18 months after restoration.Results During the 18-month follow-up period, 36 of the 38 teeth were successfully restored, and all the evaluated items reached grade A or B. Six months after the repair, one prosthesis had fallen off, resulting in a success rate of 97.37% (37/38). The success rate remained 97.37% (37/38) 12 months after the repair; 18 months after the repair, another prosthesis had failed(Marginal integrity and anatomical morphology were grade C), reducing the success rate to 94.74% (36/38). There was no significant difference in the success rate of resin inlay repair at 6, 12 or 18 months (χ 2=0.518, p=0.772). Conclusion Composite resin inlay restoration is an alternative method for repairing primary molars with large defects after root canal treatment.
Objective To explore the etiology, clinical manifestations, diagnosis and treatment of verruciform xanthoma (VX) in adolescents to provide a reference for clinical diagnosis and treatment.Methods The clinical data of a case of a palatal mass in a juvenile were analyzed, and the related literature was reviewed.Results The palatal mass was proven to be VX by histopathological examination. Surgical resection was performed, and the prognosis was good. A review of the literature shows that VX is a rare benign mucosal skin lesion of an unknown etiology, with an incidence of approximately 0.025%-0.094%; VX is mostly found in middle-aged people, with no significant difference by sex. The clinical manifestations are similar to those of a variety of diseases, such as squamous papilloma, verruca vulgaris, fibroma, warty carcinoma and squamous cell carcinoma, which are not easy to distinguish and require histopathological diagnosis. The treatment of choice is surgical excision, with a low recurrence rate.Conclusion In the clinical experience of solitary mucosal masses in juveniles, it is necessary to send biopsy for pathological examination and avoid overtreatment.
Normal development of the velopharyngeal structures is key to obtaining good velopharyngeal closure. In the assessment of velopharyngeal closure and normal pronunciation, a variety of instruments can be used to detect and assist in the diagnosis of velopharyngeal dysfunction. In the past, the assessment of velopharyngeal closure often used two-dimensional imaging or relied solely on the subjective assessment of the phonetician. With the development of science and technology, magnetic resonance imaging (MRI) has become widely used in the evaluation of velopharyngeal structures and functions as an ideal examination method. This article reviews the current capabilities and limitations in evaluating velopharyngeal closure, as well as recent research on the structures and functions of the velopharyngeal using static MRI, dynamic MRI, three-dimensional MRI reconstructions and diffusion tensor imaging (DTI) techniques; in addition, this work explores the role and significance of MRI technology in evaluating the structures and functions of the velopharyngeal. A review of the literature shows that static MRI is simple in terms of the scanning mode, has easily adjustable parameters, and clearly shows the anatomical structures of palatopharyngeal in resting or transient vocal states. Dynamic MRI can capture the anatomical changes of the palatopharyngeal in a more complex pronunciation state and obtain accurate dynamic images of the velopharyngeal closure process for the study of speech pathology. Three-dimensional MRI reconstructions are usually used in fine scanning of the velopharyngeal structures in a resting state; although this method takes a long time, the images obtained are clear and reliable. This approach can be used for three-dimensional reconstruction analysis and three-dimensional finite element analysis, and it can be used to help plan an operation and evaluate the effect of the surgery. DTI is a new method for observing the contractile function of muscles by observing the locus of water molecules in muscles. DTI can be used to analyze and study many muscles involved in velopharyngeal closure.
Gingival biotypes are used to describe the morphological characteristics of periodontal tissue. According to thickness, the gingiva can be divided into thin and thick gingival biotypes. The gingival biotype has a wide range of influential factors and can be measured by various methods. In the process of oral treatment, to achieve good therapeutic effects and obtain a clear prognosis, it is particularly important to study the gingival biotype. This article reviews the influential factors and methods for assessing the gingival biotype. The results of literature review show that, factors influencing the gingival biotype include individual factors related to sex, age and ethnicity and oral soft and hard tissue characteristics related to crown shape, tooth position, alveolar bone thickness, keratinized gingival width and gingival papilla height. Gingival hypertrophy mainly occurs in young males and in people with square and round crowns, thicker alveolar bones and wider keratinized gingiva. With the development of methods for measuring the gingival biotype ranging from the traditional direct observation method, direct measurement methods and periodontal exploration methods to cone beam computed tomography and ultrasound have increased the accuracy of these measurements.
Gingival recession is one of the common oral symptoms. Periodontal soft tissue defects caused by gingival recession and problems related to aesthetics, prosthetics and orthodontic treatment have garnered increasing attention. This article reviews the etiology, classification and treatment of gingival recession to provide a reference for the diagnosis and treatment of gingival recession. Anatomical characteristics of teeth, bacterial and viral infection, Occlusion trauma, Improperbrushing methods and other daily behaviors and iatrogenic factors may lead to gingival recession. Miller classification is the most commonly used classification standard. It is divided into 4 degrees according to the relationship between gingival recession and the association between the gingival membrane and the loss of adjacent alveolar bone or interdental papilla. Gingival surgeries, such as coronally advanced flap, laterally positioned flap, subepithelial connective tissue graft for Miller Ⅰ degrees and Ⅱ gingival recession retreat, obtain a more satisfactory success rate. Regarding the Ⅲ degree gingival recession, the postoperative curative effect is poor and can only cover part of the root. Regarding Ⅳ degrees gingival recession, surgery cannot reach the root surface coverage. For patients with Miller Ⅳgingival recession caused by severe periodontitis, the surgical treatment is poor, and repair methods, such as sputum, can also be considered. In recent years, a variety of biological materials have been jointly applied to gingival surgery, such as tooth enamel matrix derivative (EMD), allograft acellular dermal matrix (ADM), porcine collagen matrix (PCM) and platelet-rich fibrin (PRF). The use of these biomaterials can improve root coverage, increase gingival thickness and keratinized gingival width, avoid the requirement of palatal flap removal, reduce the surgical risk and increase patient compliance.
Digital implant guides have enabled "repair-oriented" implant restoration to become a reality by allowing an implant to be designed for an ideal site, maximizing the use of existing alveolar bone, and increasing the predictability of the restorative effect. This paper reviews the classification of digital guides and the related factors affecting the accuracy of digital guides to provide a reference for clinical doctors in practical applications. Digital guides can be divided into the categories of mucosal support, bone support, dental support and mixed support according to the retention mode. The manufacture and use of digital implant guides involve a series of processes, such as data acquisition, design and manufacture of the implant guide, and guided surgery. The accuracy of digital implant guides depends on all accumulated and interactive errors involved in the process from data acquisition to surgery. According to the process of guide plate fabrication and implant placement, errors in all aspects can be reduced to improve the accuracy of guide plate application.
This work is licensed under Creative Commons Attribution 4.0 License.
