Sialorrhea is a group of symptoms characterized by excessive accumulation of saliva in the mouth and unconscious overflow from the mouth. It can be divided into physiological sialorrhea and pathological sialorrhea. The etiology of sialorrhea is complex. Local oral factors, systemic diseases, drug induction or psycho-physiological factors can lead to excessive saliva secretion or excessive saliva storage in the mouth, which can lead to sialorrhea. Physiological sialorrhea generally does not require treatment, while different treatment strategies are needed in cases of pathological sialorrhea. There are many treatments for sialorrhea, including oral and maxillofacial system training, drugs, botulinum toxin injection, surgical treatment, and less commonly, traditional Chinese medicines, radiotherapy and neuromuscular electrical stimulation therapy. For different patients, different treatment methods should be adopted, and the treatment should be gradual. To correct the abnormalities in the oral and maxillofacial regions, the primary disease should be treated, contact with/the use of substances inducing salivation should be stopped, or psychological treatment should be administered, combined with oral and maxillofacial system training; if the effect is not good, invasive treatment, such as surgery, should be considered. At present, there are no unified, clear diagnostic criteria or simple and effective treatments in the clinic. In this paper, the etiology, diagnosis and treatment of sialorrhea, combined with our group′s many years of experience in the diagnosis and treatment of sialorrhea, are reviewed to provide a useful reference for the clinical diagnosis and treatment of sialorrhea.
Objective To study the effect of continuous static pressure on the endoplasmic reticulum of human periodontal ligament cells (hPDLCs) and the mechanism of osteogenic differentiation.Methods hPDLCs cultured in vitro were subjected to 1 g/cm 2 of continuous compressive pressure (CCP) by custom-made, round, glass panes for 0, 2, 4, and 6 h, respectively. Alkaline phosphatase staining was used to detect osteogenic differentiation, and real-time quantitative PCR was used to detect the expression of protein kinase receptor-like ER kinase (PERK), eukaryotic translation initiation factor 2α (eIF2α), and transcription activation factor 4 (ATF-4). The 0 h loading group was the control group. Results After CCP treatment, the alkaline phosphatase staining of hPDLCs was blue-violet and significantly stronger than that of cells in the control group. The expression levels of PERK and ATF4 in the hPDLCs after CCP treatment were higher than those of cells in the control group (P < 0.05) and increased over time (P < 0.05). The expression of eIF2α was lower in the experimental groups than in the control group (P < 0.05) and decreased over time (P < 0.05).Conclusion Mechanical stimulation can activate ERS in hPDLCs, leading to enhanced PERK-eIF2α-ATF4 signaling and inducing osteogenic differentiation.
Objective To study the effects of platelet-rich fibrin extract (PRFe) and platelet-derived growth factor (PDGF) released from PRFe on the proliferation of human gingival fibroblasts (HGFs) and to provide an experimental basis for its application in promoting gingival soft tissue increment.Methods Platelet-rich fibrin (PRF) was transformed into PRFe by tissue culture. The three-dimensional structure of PRF was observed by electron microscopy, and the content of PDGF in PRF was quantitatively determined by ELISA. The ratios of PRFe examined were 2.5% PRFe, 5% PRFe, 7.5% PRFe, 10% PRFe, 12.5% PRFe and 15% PRFe. Gingival fibrosis was detected by the CCK-8 method. After determining the optimal concentration of PRFe, flow cytometry was used to detect the effect of PRFe on the proliferation cycle of human gingival fibroblasts, and the effect of PDGF on the proliferative activity of gingival fibroblasts was observed by neutralizing the release of PDGF.Results PRF is a three-dimensional reticular structure that contains a large number of growth factors. PDGF release peaked on the 7th day. The proliferative activity of HGFs cultured with different concentrations of PRFe was concentration-dependent, but the effect was optimal at 5% PRFe (P < 0.05). There were no significant differences in the effect of subsequent concentration increases on the proliferation of HGFs (P > 0.05). The flow cytometry results showed that 5% PRFe could significantly stimulate the S-phase division and proliferation of gingival fibroblasts, while the PDGF neutralization test showed that the proliferation of gingival fibroblasts was significantly inhibited by the neutralization of PDGF.Conclusion Overall 5% PRFe had the best effect on promoting gingival fibroblast proliferation in vitro. PDGF released from PRF plays an important role in promoting the proliferation of gingival fibroblasts.
Objective To compare and analyze the effects of thermal etching on the shear strength of zirconia substrates and decorative ceramics. Methods A total of 20 specimens made with zirconia ceramics were randomly divided into an observation group and a control group with 10 cases in each group. The control group was treated with sandblasting, while the observation group was treated with sandblasting and thermal etching. The surface characteristics were examined by scanning electron microscope (SEM) and phase analysis of X-ray diffraction (XRD), and the shear strength was tested using a universal testing machine. The characteristics of surface destruction were examined by SEM.Results SEM showed that the peak structure was observed in both groups. The observation group exhibited deep fissures, and the control group exhibited small fissures. The diffraction peaks of the two groups are similar. The T (101) peak is the main peak, and both groups exhibit an M (111) peak. However, the peak intensity is relatively small. The relative levels of monoclinic zirconia were 15.16% in the observation group and 16.22% in the control group. The shear bond strength of the observation group was 24.74 ± 3.02 MPa, which was significantly higher than that of the control group at 21.09 ± 2.58 MPa. The difference was statistically significant (t=2.599, P=0.021). In the control group, the porcelain residue on the zirconia surface was minimal at low magnification, and the zirconia substrate was obviously exposed. The zirconia surface was similar to cristae obliqua at high magnification, and the porcelain exhibited a scattered distribution. In the observation group, a large amount of residual veneer porcelain remained on the zirconia surface at low magnification, but considerable porcelain was observed at high magnification.Conclusion Thermal etching and sandblasting treatment can improve the shear strength of zirconia substrate.
Objective To explore the clinical application of an extended clavicular epithelial flap with a transverse cervical arterial blood supply in the repair of postoperative soft tissue defects in elderly patients with oral cancer.Methods From January 2015 to June 2018, 24 elderly patients with oral cancer were admitted to the Department of Oral and Maxillofacial Surgery, Hainan Provincial People′s Hospital, including 15 males and 9 females, aged 65-82 years, with an average age of 71.8 years. The supraclavicular epithelial flap was used to repair the soft tissue defect after radical resection of the oral cancer. The flap was at least 4 cm × 6 cm, and the maximum size was 7 cm × 9 cm. All patients completed a University of Washington Quality of Life (UW-QOL) survey 6 months after surgery, and a subjective satisfaction survey was conducted.Results The prolonged clavicular epithelial flap survival rate was 91.6% (22/24). The patients had good speech and swallowing function, hidden scars and no obvious sequelae. The average UW-QOL score 6 months after the operation was 76.5 ± 6.4. The follow-up satisfaction rate was 87.5% (21/24).Conclusion An extended clavicular epithelial flap with a transverse cervical arterial supply is reliable, of moderate thickness, is simple to implement, causes little trauma at the donor site, and yields a relatively concealed donor site. It is suitable for the simultaneous repair of soft tissue defects in elderly patients with oral cancer.
Objective To explore the clinical effect of the alveolar crest approach in the treatment of odontogenic maxillary sinusitis and the repair of edentulous implants in this area.Methods This was a retrospective case series of 20 patients with odontogenic sinusitis. The pathogenesis in each case was investigated. After elimination of the dental origin, each patient was treated with flushing, drainage and anti-inflammatories through the alveolar crest approach. Postoperative CBCT reexamination was performed to evaluate the therapeutic effect. Maxillary sinus elevation surgery with simultaneous or delayed implantation was performed after maxillary sinusitis healing was confirmed. The patients were followed postoperatively.Results Twenty patients with odontogenic sinusitis were treated by the alveolar crest approach, and 17 were cured, for a cure rate of 85%. Among them, 17 of the maxillary sinusitis patients were followed for 1 year, with good results.Conclusion The alveolar crest approach is feasible for the treatment of odontogenic maxillary sinusitis and can serve as a minimally invasive method for the repair of edentulism in this area and implantation.
Objective To summarize experience treating dog bites in the oral and maxillofacial regions of children and provide a reference for clinical practice. Methods Nineteen children with dog bite wounds in the maxillofacial region were treated from July 2011 to June 2018 with primary debridement and suturing. A rabies vaccine, tetanus vaccine and human immunoglobulin as a passive immune agent were given via intramuscular injection. Anti-inflammatory therapy with amoxicillin and clavulanate potassium or other antibiotics. Follow-up observation and a retrospective analysis of the treatment effect were carried out. Results After treatment, among the 19 pediatric patients, 18 cases showed primary healing and 1 case showed secondary healing. The follow-up period ranged from six months to seven and a half years. No cases of rabies occurred. Conclusion For the treatment of patients with maxillofacial dog bite wounds, the first stage debridement and suture can reduce the scar after operation and is beneficial to the recovery of face.
Objective To study the stress distribution in noncarious cervical lesions (NCCLs) of maxillary first premolars under the conditions of different defect shapes, restorative materials and loading directions and to analyze the effect of different conditions on the treatment of NCCLs.Methods Three-dimensional finite element models of cervical defects of the maxillary first premolar were established by oral CBCT in a healthy adult. According to the shape of the cavity bottom, the cavity was divided into two groups: acute angle and obtuse angle. In addition to healthy dental controls, defects in each group were simulated and virtually treated with three kinds of restorative materials (glass ionomer cement, Z350 resin and bulk resin) as research objects. Four kinds of loads (normal occlusal vertical load, normal occlusal lateral load, traumatic occlusal vertical and lateral load) were applied. The lateral load of occlusion was 100 N, and the stress distribution in the prosthesis was analyzed.Results Under the condition with different cavity types that the NCCL near the pulp line was sharp, the stress in the wedge-shaped defect repair material was concentrated and significantly higher than that in the other obtuse groups. Under the condition with different repair materials, in the bottom of the acute cavity, the glass ionomer cement showed less stress than the two kinds of resin. The maximum stress in the prosthetic material in the traumatic occlusion state was significantly higher than that in the normal occlusion state, and the lateral load was more concentrated than the vertical load on the neck defect.Conclusion The stress in maxillary first premolar NCCLs is affected by the shape of the cavity and the loading direction. A simulated acute cavity morphology and traumatic force mode produced concentrated stress in the material used to repair the NCCL. Before restoration, the bottom of an acute cavity should be adjusted to an obtuse angle. After treatment, the bite of the affected tooth adjusts over time to reduce traumatic occlusion, which is beneficial for improving the service life of the filling material.
Objective To study the anatomical characteristics of the root and root canal system of the mandibular second permanent molar in the Uygur people and provide a reference for clinical practice.Methods A total of 125 mandibular second permanent molars were extracted from Uygur patients in hospitals in the Xinjiang Uygur Autonomous Region. Three-dimensional reconstruction was performed after micro-CT scanning. The number of root canals, the root canal type (Weine classification and Fan′s C-shaped canal classification) and the occurrence of lateral accessory canals were observed.Results A sex difference was not detected in the root number or root form (χ 2 = 1.277, P = 0.259). The incidence of 2-rooted molars was 70.4% (n = 88); type 2-1 canals were most common in the mesial root, with an incidence of 29.5%, followed by type 1-1 and 2-2 canals (each with an incidence of 26.1%), and the distal root mostly had a type 1-1 canal (96.6%). The incidence of single-rooted molars was 28.8%, and the frequency of C-shaped (n = 28) and non-C-shaped (n = 8) single-rooted molars was 22.4% and 6.4%, respectively. A three-rooted molar was detected in one case. The incidence of accessory canals was 65.2%.Conclusion Uygur mandibular second molars are mainly composed of two roots, and the incidence of a single root and root canal fusion is low (including C-shaped canals). Two-rooted molars frequently have two mesial canals and one distal canal.
Objective To explore the application and effect of the PDCA cycle nursing management model in the treatment of peri-implant mucositis.Methods Thirty patients with peri-implant mucositis were treated nonsurgically. Before treatment, the 30 patients had no history of systemic diseases, drug allergies, or bad habits. According to the principle of single-blind randomized control, the patients were divided into two groups: 15 patients were assigned to the control group and received routine clinical nursing and oral hygiene education according to the doctor′s prescription; and 15 patients were assigned to the intervention group, in which the PDCA cycle nursing management model was adopted. The four steps of “plan, do, check and act” were carried out. The plaque index (PL), gingival index (GI) and probe depth (PD) in the two groups were recorded before treatment and 3 and 6 months after treatment.Results There was no significant difference in the PL, GI or PD between the intervention group and the control group before treatment (P > 0.05). Three months after treatment, the PL in the intervention group was 1.25 ± 0.44, while the PL in the control group was 1.49 ± 0.39, with a significant difference (t=2.56, P=0.008); the GI in the intervention group was 1.21 ± 0.43, while the GI in the control group was 1.56 ± 0.37, with significant difference (t=2.94, P=0.006); and the PD in the intervention group was 4.39 ± 0.41 while the PD in the control group was 4.47 ± 0.52 mm, with no significant difference (t=2.24, P=0.062). Six months after treatment, the PL in the intervention group was 1.26 ± 0.48, while the PL in the control group was 1.51 ± 0.42, with a significant difference (t=2.66, P=0.007); the GI in the intervention group was 1.34 ± 0.28, while the GI in the control group was 1.74 ± 0.48 (t=2.98, P=0.008); and the PD in the intervention group was 4.46 ± 0.52 mm, while the PD in the control group was 4.54 ± 0.66, with no significant difference (t=2.28, P=0.077).Conclusion The PDCA cycle nursing management model can enhance patients′ awareness of oral health maintenance, reduce gingival plaque accumulation, and effectively improve the health status of peri-implant tissues.
Objective To explore the influence of the SmartClip self-ligating bracket and traditional metal bi-wing brackets on plaque control and to provide a reference for the oral healthcare of orthodontic patients.Methods The patients were divided into the SmartClip self-ligating bracket group, the metal bi-wing bracket group, and the control group, consisting of untreated volunteers, and the patients were examined before treatment, 1 month after the treatment started, 3 months after the treatment started, and when the treatment ended. The oral hygiene status was recorded at four time points, and the plaque index of the following six teeth was compared among the time points: the upper-right central incisor (UR1), the lower-left central incisor (LL1), the upper-right first molar (UR6), the lower-left first molar (LL6), and the upper left canine (UL3) and the lower-right canine (LR3).Results Compared with before treatment, after first month, third month and end of treatment the plaque index of LL1, LR3, LL6 and UR6 in both the SmartClip self-ligating bracket group and the traditional metal bi-wing bracket group was increased, and the difference was statistically significant (P < 0.05). There was no significant difference in PLI index between the end of treatment and 3 months after orthodontic treatment (P > 0.05). There was no statistically significant difference in PLI index in the control group at each time period (P > 0.05). After three months of orthodontic treatment, the plaque index of LL1 and LR3 in the SmartClip self-ligating bracket group was higher than that in the traditional metal bi-wing bracket group, and the difference was statistically significant (P < 0.05).Conclusion Lower anterior and posterior areas are susceptible to plaque accumulation in treatment with fixed orthodontic appliances. The SmartClip self-ligating bracket system has no advantage over the traditional metal bi-wing bracket in terms of oral hygiene.
Enterococcus faecalis is an important pathogen in pulp periapical disease that has been widely studied in recent years. A large number of studies have shown that the high detection rate of Enterococcus faecalis in root canals with persistent or secondary infection after root canal therapy is closely related to the failure of root canal therapy. The presence of Enterococcus faecalis in periapical pulp disease is related to its pathogenicity and virulence factors. Enterococcus faecalis can directly invade host tissues or induce immune inflammation in host tissues, resulting in periapical pulp tissue damage and lesions. Enterococcus faecalis has a strong tolerance to conventional root canal antibiotics and disinfection methods and is difficult to completely remove from the complex root canal system. How to fight Enterococcus faecalis infection has become an important direction in the treatment of pulp periapical disease. This article reviews the pathogenic mechanism of Enterococcus faecalis infection in pulp periapical disease and the progress in its treatment.
?Preterm low birth weight newborns are prone to complications during growth and development, such as growth retardation and infectious diseases, and the mortality rate of high-risk infants is higher than that of healthy newborns. Epidemiological data show that periodontal disease in pregnant women is correlated with preterm?low birth weight. Periodontal disease in pregnant women is one of the risk factors for adverse pregnancy outcomes, such as ?preterm? ?low birth weight. This paper addresses the correlation between maternal periodontal disease and ?preterm ?low birth weight, the influence of periodontal treatment on the incidence of preterm ?low birth weight, and premature birth caused by maternal periodontal disease. The mechanism of infant weight is reviewed. The results of this review show that the current studies confirm the correlation between maternal periodontal disease and ?preterm?low birth weight. However, the causal relationship between maternal periodontal disease and preterm ?low birth weight is not fully elucidated, and the specific mechanism and approach are not clear. A possible mechanism is that periodontal pathogens in pregnant women pass through the placental barrier to influence pregnancy outcomes. Therefore, more in-depth research is needed on the specific mechanism, approach, intervention and treatment based on the relationship between these two factors.
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